False-negative sentinel lymph node biopsy in head and neck melanoma

Matthew W. Miller, John Vetto, Marcus M. Monroe, Roshanthi Weerasinghe, Peter Andersen, Neil D. Gross

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective. The results of sentinel lymph node biopsy (SLNB) can be useful for staging and deciding on adjuvant treatment for patients with head and neck melanoma. False-negative SLNB can result in treatment delay. This study aimed to evaluate the characteristics and outcome of patients with false-negative SLNB in cutaneous melanoma of the head and neck. Study Design. Longitudinal cohort study using a prospective institutional tumor registry. Setting. Academic health center. Subjects and Methods. Data from 153 patients who underwent SLNB for melanoma of the head and neck were analyzed. False-negative biopsy was defined as recurrence of tumor in a previously identified negative nodal basin. Statistical analysis was performed on registry data. Results. Positive sentinel lymph nodes were identified in 19 (12.4%) patients. False-negative SLNB was noted in 9 (5.9%) patients, with a false-negative SLNB rate of 32.1%. Using multivariate regression analysis, only examination of a single sentinel lymph node was a significant predictor of false-negative SLNB (P = .01). The mean treatment delay for the false-negative SLNB group was 470 days compared with 23 days in the positive SLNB group (P <.001). The 2-year overall survival of patients with false-negative SLNB was 75% compared with 84% and 98% in positive and negative SLNB groups, respectively (P = .02). Conclusions. False-negative SLNB is more likely to occur when a single sentinel lymph node is harvested. There is significant treatment delay in patients with false-negative SLNB. False-negative SLNB is associated with poor outcome in patients with melanoma of the head and neck.

Original languageEnglish (US)
Pages (from-to)606-611
Number of pages6
JournalOtolaryngology - Head and Neck Surgery
Volume145
Issue number4
DOIs
StatePublished - Oct 2011

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Sentinel Lymph Node Biopsy
Melanoma
Neck
Head
Registries
Therapeutics

Keywords

  • Cutaneous head and neck melanoma
  • False-negative
  • Sentinel lymph node biopsy
  • Survival

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery
  • Medicine(all)

Cite this

False-negative sentinel lymph node biopsy in head and neck melanoma. / Miller, Matthew W.; Vetto, John; Monroe, Marcus M.; Weerasinghe, Roshanthi; Andersen, Peter; Gross, Neil D.

In: Otolaryngology - Head and Neck Surgery, Vol. 145, No. 4, 10.2011, p. 606-611.

Research output: Contribution to journalArticle

Miller, Matthew W. ; Vetto, John ; Monroe, Marcus M. ; Weerasinghe, Roshanthi ; Andersen, Peter ; Gross, Neil D. / False-negative sentinel lymph node biopsy in head and neck melanoma. In: Otolaryngology - Head and Neck Surgery. 2011 ; Vol. 145, No. 4. pp. 606-611.
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abstract = "Objective. The results of sentinel lymph node biopsy (SLNB) can be useful for staging and deciding on adjuvant treatment for patients with head and neck melanoma. False-negative SLNB can result in treatment delay. This study aimed to evaluate the characteristics and outcome of patients with false-negative SLNB in cutaneous melanoma of the head and neck. Study Design. Longitudinal cohort study using a prospective institutional tumor registry. Setting. Academic health center. Subjects and Methods. Data from 153 patients who underwent SLNB for melanoma of the head and neck were analyzed. False-negative biopsy was defined as recurrence of tumor in a previously identified negative nodal basin. Statistical analysis was performed on registry data. Results. Positive sentinel lymph nodes were identified in 19 (12.4{\%}) patients. False-negative SLNB was noted in 9 (5.9{\%}) patients, with a false-negative SLNB rate of 32.1{\%}. Using multivariate regression analysis, only examination of a single sentinel lymph node was a significant predictor of false-negative SLNB (P = .01). The mean treatment delay for the false-negative SLNB group was 470 days compared with 23 days in the positive SLNB group (P <.001). The 2-year overall survival of patients with false-negative SLNB was 75{\%} compared with 84{\%} and 98{\%} in positive and negative SLNB groups, respectively (P = .02). Conclusions. False-negative SLNB is more likely to occur when a single sentinel lymph node is harvested. There is significant treatment delay in patients with false-negative SLNB. False-negative SLNB is associated with poor outcome in patients with melanoma of the head and neck.",
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N2 - Objective. The results of sentinel lymph node biopsy (SLNB) can be useful for staging and deciding on adjuvant treatment for patients with head and neck melanoma. False-negative SLNB can result in treatment delay. This study aimed to evaluate the characteristics and outcome of patients with false-negative SLNB in cutaneous melanoma of the head and neck. Study Design. Longitudinal cohort study using a prospective institutional tumor registry. Setting. Academic health center. Subjects and Methods. Data from 153 patients who underwent SLNB for melanoma of the head and neck were analyzed. False-negative biopsy was defined as recurrence of tumor in a previously identified negative nodal basin. Statistical analysis was performed on registry data. Results. Positive sentinel lymph nodes were identified in 19 (12.4%) patients. False-negative SLNB was noted in 9 (5.9%) patients, with a false-negative SLNB rate of 32.1%. Using multivariate regression analysis, only examination of a single sentinel lymph node was a significant predictor of false-negative SLNB (P = .01). The mean treatment delay for the false-negative SLNB group was 470 days compared with 23 days in the positive SLNB group (P <.001). The 2-year overall survival of patients with false-negative SLNB was 75% compared with 84% and 98% in positive and negative SLNB groups, respectively (P = .02). Conclusions. False-negative SLNB is more likely to occur when a single sentinel lymph node is harvested. There is significant treatment delay in patients with false-negative SLNB. False-negative SLNB is associated with poor outcome in patients with melanoma of the head and neck.

AB - Objective. The results of sentinel lymph node biopsy (SLNB) can be useful for staging and deciding on adjuvant treatment for patients with head and neck melanoma. False-negative SLNB can result in treatment delay. This study aimed to evaluate the characteristics and outcome of patients with false-negative SLNB in cutaneous melanoma of the head and neck. Study Design. Longitudinal cohort study using a prospective institutional tumor registry. Setting. Academic health center. Subjects and Methods. Data from 153 patients who underwent SLNB for melanoma of the head and neck were analyzed. False-negative biopsy was defined as recurrence of tumor in a previously identified negative nodal basin. Statistical analysis was performed on registry data. Results. Positive sentinel lymph nodes were identified in 19 (12.4%) patients. False-negative SLNB was noted in 9 (5.9%) patients, with a false-negative SLNB rate of 32.1%. Using multivariate regression analysis, only examination of a single sentinel lymph node was a significant predictor of false-negative SLNB (P = .01). The mean treatment delay for the false-negative SLNB group was 470 days compared with 23 days in the positive SLNB group (P <.001). The 2-year overall survival of patients with false-negative SLNB was 75% compared with 84% and 98% in positive and negative SLNB groups, respectively (P = .02). Conclusions. False-negative SLNB is more likely to occur when a single sentinel lymph node is harvested. There is significant treatment delay in patients with false-negative SLNB. False-negative SLNB is associated with poor outcome in patients with melanoma of the head and neck.

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