Sentinel lymph node assessment in melanoma: current state and future directions

Assessment of sentinel lymph node status is an important step in the evaluation of patients with melanoma for both prognosis and therapeutic management. Pathologists have an important role in this evaluation. The methodologies have varied over time, from the evaluation of dimensions of metastatic burden to determination of the location of the tumour deposits within the lymph node to precise cell counting. However, no single method of sentinel lymph node tumour burden measurement can currently be used as a sole independent predictor of prognosis. The management approach to sentinel lymph node-positive patients has also evolved over time, with a more conservative approach recently recognised for selected cases. This review gives an overview of past and current status in the field with a glimpse into future directions based on prior experiences and clinical trials.

Automated summary

Assessment of sentinel lymph node status is crucial for melanoma patients' prognosis and therapeutic management, and pathologists play a vital role in this evaluation. Various methods have been used, including evaluating metastatic burden dimensions, determining tumor deposit locations within lymph nodes, and precise cell counting. However, no single method can independently predict prognosis. The management approach for sentinel lymph node-positive patients has also evolved, with a more conservative approach recognized for selected cases. This review provides an overview of past and current advancements in the field, along with potential future directions based on prior experiences and clinical trials.