FIRES & SENTOR (sentinel node mapping)
Mapping and removing only the first draining lymph nodes finds spread as reliably as removing all of them, with far less lymphoedema.
FIRES (Lancet Oncology 2017, 385 patients): sensitivity 97.2%, negative predictive value 99.6%. SENTOR (JAMA Surgery 2021, 156 high-grade patients): sensitivity 96%, NPV 99%. Sentinel node biopsy is now standard in apparent early-stage disease including high-grade histologies.
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