NTTS 2017

The biology of the primary tumor controls the development of distant metastasis in patients with melanoma. Because of this, the detection of sentinel lymph node metastasis simply represents a biologic marker of the aggressiveness of the primary tumor. The incubator hypothesis implies that treatment of nodal metastasis has the potential to halt further disease spread and to improve survival. The incubator hypothesis also implies that treatment of lower volumes of nodal metastases through completion lymphadenectomy should be associated with the greatest benefit due to decreased disease incubation time. However, current data questions the validity of the incubator hypothesis since studies have shown that control of nodal micrometastases through completion lymphadenectomy is associated with no survival benefit. These results show that sentinel lymph node disease simply represents a marker for metastasis and that sentinel lymph node biopsy is a crucial staging tool which provides information on the biology of the primary tumor.