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Il Giornale di Chirurgia

Sentinel node biopsy in cutaneous melanoma.
Our personal experience in ten years of activity (1999-2008)

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Abstract
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Cutaneous melanoma represents a malignant neoplasia with incidence
that still doubles every ten years for unknown causes. The primary
treatment was and remains up today fundamentally surgical in
the I and II stadium (as AJCC classification). It consists according to
the thickness in the radicalization to two centimetres around the lesion
and in the search of the lymph node sentinel (LS). The concept of LS
has been developed from Morton et al. and was established in 1990 after
having shown that the combination of the preoperatory lymphoscintigraphic
study with the use of a vital dye allows with high reliability
and precision the individualization and therefore the removal of
the LS, defined such the lymph node that drains a defined cutaneous
area and therefore is the first structure met by the neoplastic cells. Since
it seems that, in the majority of the cases, at least as it regards the initial
stadiums of the illness, initially the neoplasia spreads for by lymphatic
it is the LS the first one to be involved in the case of lymphatic
metastases, therefore its negativity deposes for the negativity of the whole
lymphatic station. Therefore the biopsy of the LS solves the problem of
the preventive lymphoadenectomy rather than waiting for some evidence
of lymphnode metastasis.

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