Objective:To determine the feasibility of sentinel lymph node mapping in local and in-transit recurrent melanoma.Summary Background Data:The accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy (LM/SL) for identification of occult lymph node metastases is well established in primary melanoma. We hypothesized that LM/SL could be useful to detect regional node metastases in patients with isolated local and in-transit recurrent melanoma (RM).Methods:Review of our prospective melanoma database of 1600 LM/SL patients identified 30 patients who underwent LM/SL for RM. Patients with tumor-positive sentinel nodes (SNs) were considered for completion lymph node dissection.Results:Of the 30 patients, 17 were men and 13 were women; their median age was 57 years (range, 29ndash;86 years). Primary lesions were more often on the extremities (40) than the head and neck (33) or the trunk (8). At least 1 SN was identified in each lymph node basin that drained an RM. Of the 14 (47) patients with tumor-positive SNs, 11 (78) underwent complete lymph node dissection; 4 had tumor-positive non-SNs. The median disease-free survival after LM/SL was 16 months (range, 1ndash;108 months) when an SN was positive and 36 months (range, 6ndash;132 months) when SNs were negative. At a median follow-up of 20 months (range, 2ndash;48 months), there were no dissected basin recurrences after a tumor-negative SNs.Conclusions:LM/SL can accurately identify SNs draining an RM, and the high rate of SN metastases and associated poor disease-free survival for patients with tumor-positive SN suggests that LM/SL should be routinely considered in the management of patients with isolated RM.
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