Predictive Factors for Sentinel Lymph Node Positivity in Melanoma Patients—The Role of Liquid Biopsy, MicroRNA and Gene Expression Profile Panels

The identification of predictive factors for sentinel lymph node (SLN) positivity in melanoma patients is crucial for accurate staging, prognosis, and personalized therapeutic decisions. This review synthesizes recent advancements in molecular and clinicopathological predictors, with a particular focus on liquid biopsy and gene expression profiling (GEP) tools. Emerging evidence highlights the significant role of miRNAs in melanoma progression, metastatic potential, and lymphatic spread. Clinicopathological factors such as Breslow thickness, ulceration, and mitotic rate remain critical, while GEP provides additional precision by uncovering tumor-specific molecular pathways. By integrating these tools, clinicians can improve risk stratification, reduce unnecessary procedures, and personalize management strategies.