This is an unprecedented time. It is the dedication of healthcare workers that will lead us through this crisis. Thank you for everything you do.

      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    Sentinel Lymph Node Biopsy for Melanoma (beta)

    Based on guidelines from the American Society of Clinical Oncology and the Society of Surgical Oncology.

    Strength
    Strong recommendation
    Moderate recommendation
    Weak recommendation
    Evidence
    High quality evidence
    Intermediate-high quality evidence
    Intermediate quality evidence
    Low-intermediate quality evidence
    Low quality evidence
    Insufficient evidence

    Sentinel Lymph Node (SLN) Biopsy

    Thin Melanomas
    1. Routine SLN biopsy is not recommended for patients with melanomas that are T1a (nonulcerated lesions <0.8 mm in Breslow thickness). SLN biopsy may be considered for T1b patients (0.8 to 1.0 mm Breslow thickness or <0.8 mm Breslow thickness with ulceration) after a thorough discussion with the patient of the potential benefits and risks of harm associated with the procedure.
    Intermediate-thickness Melanomas
    1. SLN biopsy is recommended for patients with melanomas that are T2 or T3 (Breslow thickness of >1.0 to 4.0 mm).
    Thick Melanomas
    1. SLN biopsy may be recommended for patients with melanomas that are T4 (>4.0 mm in Breslow thickness), after a thorough discussion with the patient of the potential benefits and risks of harm associated with the procedure.

    Completion Lymph Node Dissection (CLND)

    Completion Lymph Node Dissection
    1. Either CLND or careful observation may be offered to patients with low risk micrometastatic disease, with due consideration of clinicopathological factors. For higher risk patients, careful observation may be offered only after a thorough discussion with patients about the potential risks and benefits of foregoing CLND.
    What do the icons mean?  
    Research PaperWong SL, Faries MB, Kennedy EB, et al. Sentinel Lymph Node Biopsy and Management of Regional Lymph Nodes in Melanoma: American Society of Clinical Oncology and Society of Surgical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2018;36(4):399-413.