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A Molecular Technique Useful in the Detection of Occult Metastases in Patients with Melanoma

RT-PCR Analysis of Sentinel Lymph Nodes and Peripheral Blood

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Melanoma Techniques and Protocols

Part of the book series: Methods in Molecular Medicine ((MIMM,volume 61))

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Abstract

When cutaneous melanoma is confined to the skin, simple excision with adequate margins will usually cure the patient (1,2). Local recurrences do occur but reexcision still results in a very high cure rate. When cutaneous melanoma spreads beyond the primary site, the metastases are predominantly by way of the lymphatics. If in-transit disease or regional lymph node involvement is present, the 5-yr survival rate drops to approx 60% (1–3). Accurate staging of the locoregional lymphatic basin is thus extremely important. Pre- operative lymphoscintigraphy followed by selective lymphadenectomy has revolutionized the staging of cutaneous melanoma by delivering to the pathologist only those nodes that are most likely to contain metastatic cells (4). A close examination of these sentinel lymph nodes (SLNs) by serial sectioning and immunohistochemical staining can detect very minute quantities of melanoma. This type of detailed examination is impossible in standard lymphadenectomy specimens that can contain 20–40 lymph nodes. The standard technique used to examine large numbers of lymph nodes is to examine only 1–5% of each node using hematoxylin and eosin staining. This can obviously miss micrometastatic disease and understage the patient.

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Author information

Authors and Affiliations

  1. UMDNJ Robert Wood Johnson Medical School, NJ

    James S. Goydos (Assistant Professor of Surgery)

  2. Department of Surgery, H.Lee Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, Tampa, FL

    Douglas S. Reintgen Professor of Surgery (Program Leader, Cutaneous Oncology Program)

Authors
  1. James S. Goydos
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  2. Douglas S. Reintgen Professor of Surgery
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Editor information

Editors and Affiliations

  1. Loyola University Medical Center, Maywood, IL

    Brian J. Nickoloff MD,PhD

  2. Institute for Systems Biology, Seattle, WA

    Leroy Hood MD,PhD (President and Director) (President and Director)

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© 2001 Humana Press Inc.

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Goydos, J.S., Reintgen, D.S. (2001). A Molecular Technique Useful in the Detection of Occult Metastases in Patients with Melanoma. In: Nickoloff, B.J., Hood, L. (eds) Melanoma Techniques and Protocols. Methods in Molecular Medicine, vol 61. Humana Press. https://doi.org/10.1385/1-59259-145-0:301

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  • DOI: https://doi.org/10.1385/1-59259-145-0:301

  • Publisher Name: Humana Press

  • Print ISBN: 978-0-89603-684-0

  • Online ISBN: 978-1-59259-145-9

  • eBook Packages: Springer Protocols

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