Professor Meirion Thomas
Consultant Surgeon at The Royal Marsden Hospital, London and holder of a Personal Chair in Surgical Oncology at Imperial College London
The Sentinel Node Biopsy Procedure in Melanoma does not offer a survival advantage
Sentinel Node Biopsy has been accepted into everyday Melanoma practice, but we explore the evidence base for this procedure, exposing why it may not offer the advantages sometimes promised by clinicians.
Excision surgery: the basics
Wide excision and excision are biopsies explained
Lymph Node Surgery
Lymphadenectomy surgery is used when melanoma spreads to the lymphatics, in an attempt to remove cancerous nodes and stem further spread. The procedure is sometimes used diagnostically.
Breslow thickness and Ulceration predict survival
Breslow depth and ulceration of a primary tumour can have a significant impact on the survival time of a patient
Prognostic factors from the primary tumour
Which prognostic factors relate directly to the characteristics of the primary tumour itself rather than other components of the full staging process
Spread of melanoma to lymph nodes and prognosis
The number of lymph nodes containing melanoma is a useful and accurate prognostic factor in predicting survival, as documented in a landmark study by Balch et al in 2001.
The Lymphatic System
A network of vessels which allow the flow of lymph fluid run through the body, unfortunately they are also the key method of spread of melanoma
Pre-invasive skin lesions
Melanoma is not known for its easily recognisable precancerous states, however there are a few known pre-malignant lesions
Subungal Melanoma
Most frequently occurs under the nail of the big toe
Acral Melanoma
A melanoma which usually occurs on the foot