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01-03-2016 | Melanomas

Predictors and Survival Impact of False-Negative Sentinel Nodes in Melanoma

Authors: David Y. Lee, MD, Kelly T. Huynh, MD, Annabelle Teng, MD, Briana J. Lau, MD, Sarah Vitug, BS, Ji-Hey Lee, PhD, Stacey L. Stern, MS, Leland J. Foshag, MD, Mark B. Faries, MD

Published in: Annals of Surgical Oncology | Issue 3/2016

Abstract

Background

The status of the sentinel lymph node in melanoma is an important prognostic factor. The clinical predictors and implications of false-negative (FN) biopsy remain debatable.

Methods

We compared patients with positive sentinel lymph node biopsy (SNB) [true positive (TP)] and negative SNB with and without regional recurrence [FN, true negative (TN)] from our prospective institutional database.

Results

Among 2986 patients (84 FN, 494 TP, and 2408 TN; median follow-up 93 months), the incidence of FN-SNB was 2.8 %. While calculated FN rate was 14.5 % [84 FN/(494 TP + 84 FN) × 100], when we accounted for local/in-transit recurrence (LITR) this rate was 8.5 % [46 FN/(494 TP + 46 FN) × 100 %]. On multivariate analysis, male gender (OR 2.0, 95 % CI 1.1–3.6, p = 0.018), head/neck primaries (OR 2.5, 95 % CI 1.3–4.8, p < 0.006), and LITR (OR 3.5, 95 % CI 2.1–5.8, p < 0.001) were associated with FN-SNB. Melanoma-specific survival (MSS) for the FN group was similar to the TP group at 5 years (68 vs. 73 %, p = 0.539). However, MSS declined more for the FN group with a longer follow up and was significantly worse at 10 years (44 vs. 64 %, p < 0.001). On multivariate analysis, FN-SNB was a significant predictor of worse MSS in melanomas <4 mm in Breslow thickness (HR 1.6; 95 % CI 1.1–2.5, p = 0.021).

Conclusions

Male gender, LITR, and head and neck tumors were associated with FN-SNB. FN-SNB was an independent predictor of worse MSS in melanomas <4 mm in thickness, but this survival difference did not become apparent until after 5 years of follow-up.

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Title: Predictors and Survival Impact of False-Negative Sentinel Nodes in Melanoma
Authors: David Y. Lee, MD
Kelly T. Huynh, MD
Annabelle Teng, MD
Briana J. Lau, MD
Sarah Vitug, BS
Ji-Hey Lee, PhD
Stacey L. Stern, MS
Leland J. Foshag, MD
Mark B. Faries, MD
Publication date: 01-03-2016
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 3/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-4912-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predictors and Survival Impact of False-Negative Sentinel Nodes in Melanoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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