IS SLN BIOPSY LESS MORBID THAN ELECTIVE LYMPH NODE DISSECTION?
Removal of just 1 or 2 SLNs to stage a lymph node field should cause fewer postoperative complications compared with a full elective dissection of the field and this has been borne out in practice (28). Postoperative complications occur in about 40% of patients after elective dissection of a node field, whereas SLN biopsy causes postoperative complications in only 10%. The most severe complications such as lymphedema are also much less common. In fact, the reduced morbidity associated with SLN biopsy is one of the major factors that have driven its acceptance by patient advocates, because 70% 80% of patients have normal SLNs (13 15) and require no further lymph node surgery. DOES SLN BIOPSY IMPROVE SURVIVAL? There is some evidence that early excision of regional lymph node metastasis confers a slight survival benefit in patients with melanoma (29). Preliminary results of MSLT I were presented recently (27). This trial compared SLN biopsy, followed by immediate elective dissection of th
