Sentinel Lymphadenectomy as a Selection Criterion for Adjuvant Treatment Strategies

It has been suggested that patients with a relatively low tumor burden may benefit most from adjuvant treatment strategies [24]. If effective schedules should become available, for instance in the form of interferon-alpha in a tolerable dose [25] or a vaccine [26], micrometastasis detected by sentinel lymphadenectomy may prove to be an attractive selection criterion for these adjuvant treatments.

In this respect, the relevance of the RT-PCR technique for the detection of tyrosinase or other specific markers for the presence of melanoma cells in the sentinel lymph node has to be elucidated [9,27]. In one report, RT-PCR positivity in histologically negative sentinel nodes was associated with a recurrence rate of 10.6%, compared to a rate of 2.3% in RT-PCR-negative patients [28]. This suggests that RT-PCR is of practical value in melanoma staging and therefore could be a selection criterion for entering patients in adjuvant treatment schedules.

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