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Regional recurrence after negative sentinel lymph node biopsy for melanoma
Grant W Carlson1, Andrew J Page, Cynthia Cohen
1Department of Surgery, Winship Cancer Institute, Emory University School of Medicine, 1365C Clifton Road, Atlanta, Georgia 30322, USA. grant_carlson@emory.org
Annals of Surgery
|September 16, 2008
Summary
Sentinel lymph node (SLN) biopsy is crucial for melanoma management. Head and neck location and tumor thickness predict false-negative SLN results, impacting patient survival similarly to positive SLNs.
Area of Science:
- Oncology
- Surgical Pathology
- Dermatology
Background:
- Sentinel lymph node (SLN) biopsy is a standard procedure for melanoma staging.
- Accurate SLN assessment is vital to guide treatment and predict prognosis.
- Regional recurrence after a negative SLN biopsy warrants further investigation.
Purpose of the Study:
- To analyze regional recurrence rates in patients with negative SLN biopsy results.
- To identify predictors of false-negative (FN) SLN biopsies in melanoma.
- To compare survival outcomes between patients with FN SLN biopsies and those with positive SLNs.
Main Methods:
- Retrospective analysis of a prospective melanoma database (1994-2006).
- Inclusion of 1287 patients with successful SLN biopsy.
- Multivariate analysis to examine clinical variables impacting regional recurrence.
Main Results:
- 3.3% of patients experienced a false-negative SLN biopsy.
- Head and neck tumor site (HR 3.67) and tumor thickness (HR 1.16) predicted FN SLN biopsy.
- 5-year melanoma-specific survival was similar for FN (57.6%) and SLN-positive (60.0%) groups.
Conclusions:
- Head and neck site and tumor thickness are significant predictors of false-negative SLN biopsies.
- Factors beyond sampling error may contribute to SLN biopsy failures.
- Regional recurrence following a negative SLN biopsy does not significantly alter long-term survival compared to positive SLN findings.
