Estudio del ganglio centinela: Diagnóstico y tratamiento del melanoma maligno cutáneo, estadios I y II

survival at 5 years of patients with localized primary malignant melanoma is about 80%, compared with a 35% survival in case of lymph nodes involvement. sentinel lymph node(s) from 45 subjects with diagnosis of malignant melanoma stage i or ii was/were studied with hematoxylin-eosin (he), immunohistochemistry (ihc) and molecular biology (mb) techniques. the population was divided into three groups: he-/ihc+/mb+, where 67% patients died; he-/ihc-/mb+, where 57% died; and he-/ihc-/mb-, where 100% of the patients are alive, with no lymphadenectomy and a median follow-up of 60 months. those subjects who showed negativity with all the three methods had a null recurrence rate. data herein obtained suggest a new molecular oncological staging, which would allow the selection of patients with submicroscopic metastases for a complete treatment. moreover, several patients with no lymph node metastases should not undergo lympha-denectomies, and overtreatment could therefore be avoided.