Predictors and survival impact of false-negative sentinel nodes in melanoma

Lee, David Y., Huynh, Kelly T., Teng, Annabelle, Lau, Briana J., Vitug, Sarah, Lee, Ji-Hey, Stern, Stacey L., Foshag, Leland J. and Faries, Mark B. (2015) Predictors and survival impact of false-negative sentinel nodes in melanoma. Annals of Surgical Oncology, 23 3: 1012-1018. doi:10.1245/s10434-015-4912-6


Author Lee, David Y.
Huynh, Kelly T.
Teng, Annabelle
Lau, Briana J.
Vitug, Sarah
Lee, Ji-Hey
Stern, Stacey L.
Foshag, Leland J.
Faries, Mark B.
Title Predictors and survival impact of false-negative sentinel nodes in melanoma
Journal name Annals of Surgical Oncology   Check publisher's open access policy
ISSN 1534-4681
1068-9265
Publication date 2015-11-19
Sub-type Article (original research)
DOI 10.1245/s10434-015-4912-6
Open Access Status Not Open Access
Volume 23
Issue 3
Start page 1012
End page 1018
Total pages 7
Place of publication New York, NY, United States
Publisher Springer New York
Collection year 2016
Language eng
Formatted 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.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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