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False-negative sentinel lymph node biopsy in head and neck melanoma
Matthew W Miller1, John T Vetto, Marcus M Monroe
1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon 97239, USA.
Summary
False-negative sentinel lymph node biopsy (SLNB) in head and neck melanoma, particularly when only one node is examined, leads to significant treatment delays and poorer patient outcomes. This highlights the importance of thorough SLNB evaluation.
Area of Science:
- Oncology
- Dermatology
- Surgical Pathology
Background:
- Sentinel lymph node biopsy (SLNB) is crucial for staging cutaneous melanoma of the head and neck.
- False-negative SLNB results can delay essential adjuvant treatment.
- Understanding factors leading to false-negative SLNB is vital for improving patient management.
Purpose of the Study:
- To evaluate the characteristics and outcomes of patients with false-negative SLNB in head and neck melanoma.
- To identify predictors of false-negative SLNB.
- To assess the impact of false-negative SLNB on treatment delay and survival.
Main Methods:
- A longitudinal cohort study analyzed data from 153 patients with head and neck melanoma who underwent SLNB.
- False-negative SLNB was defined as tumor recurrence in a previously negative nodal basin.
- Statistical analysis, including multivariate regression, was performed on registry data.
Main Results:
- The false-negative SLNB rate was 32.1%, with 9 patients experiencing this outcome.
- Examination of a single sentinel lymph node was a significant predictor of false-negative SLNB (P = .01).
- Patients with false-negative SLNB faced a mean treatment delay of 470 days versus 23 days for positive SLNB (P < .001), and had lower 2-year overall survival (75% vs. 84% and 98%).
Conclusions:
- Harvesting a single sentinel lymph node increases the likelihood of a false-negative result in head and neck melanoma.
- False-negative SLNB is associated with substantial treatment delays.
- False-negative SLNB negatively impacts the prognosis for patients with head and neck melanoma.
