The European Organisation for Research and Treatment of Cancer (EORTC) has issued a new protocol for sentinel lymph node (SLN) biopsy in melanoma.
The new guidance recommends extending the distance between steps according to the short-axis dimension of the lymph node and optimising both conventional sectioning and staining procedures, including immunohistochemistry.
EORTC also provides guidance on the description of the spatial localisation of melanoma deposits in a SLN. The histopathological report should include details on the presence or absence of metastasis; the intra-nodal location of metastasis (sub-capsular, parenchymal, combined, extensive confluent and extensive multi-focal); the number of metastatic deposits (1, 2-5, 6-10, 11-20 and >20); the maximum dimension of the largest metastasis (indicating site); and the presence of extracapsular extension and naevus cells.
Presenting the recommendations in the European Journal of Cancer, EORTC said it expects the updated protocol to clarify and simplify the existing procedures and ensure a reasonable workload for the laboratory and pathologists, resulting in cost saving with no loss, and possible increase, in accuracy.