Impact of false-negative sentinel lymph node biopsy on survival in patients with cutaneous melanoma

C. Caracò, U. Marone, E. Celentano, G. Botti, N. Mozzillo

Research output: Contribution to journalArticle

Abstract

Background and Objectives: Sentinel lymph node biopsy is widely accepted as standard care in melanoma despite lack of pertinent randomized trials results. A possible pitfall of this procedure is the inaccurate identification of the sentinel lymph node leading to biopsy and analysis of a nonsentinel node. Such a technical failure may yield a different prognosis. The purpose of this study is to analyze the incidence of false negativity and its impact on clinical outcome and to try to understand its causes. Methods: The Melanoma Data Base at National Cancer Institute of Naples was analyzed comparing results between false-negative and tumor-positive sentinel node patients focusing on overall survival and prognostic factors influencing the clinical outcome. Results: One hundred fifty-one cases were diagnosed to be tumor-positive after sentinel lymph node biopsy and were subjected to complete lymph node dissection. Thirty-four (18.4%)patients with tumor-negative sentinel node subsequently developed lymph node metastases in the basin site of the sentinel procedure. With a median follow-up of 42.8 months the 5-year overall survival was 48.4% and 66.3% for false-negative and tumor-positive group respectively with significant statistical differences (P <.03). Conclusions: The sensitivity of sentinel lymph node biopsy was 81.6%, and a regional nodal basin recurrence after negative-sentinel node biopsy means a worse prognosis, compared with patients submitted to complete lymph node dissection after a positive sentinel biopsy. The evidence of higher number of tumor-positive nodes after delayed lymphadenectomy in false-negative group compared with tumor-positive sentinel node cases, confirmed the importance of an early staging of lymph nodal involvement. Further data will better clarify the role of prognostic factors to identify cases with a more aggressive biological behavior of the disease.

Original languageEnglish
Pages (from-to)2662-2667
Number of pages6
JournalAnnals of Surgical Oncology
Volume14
Issue number9
DOIs
Publication statusPublished - Sep 2007

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Keywords

  • Cutaneous melanoma
  • False-negative
  • Lymph node metastases
  • Sentinel biopsy

ASJC Scopus subject areas

  • Oncology
  • Surgery

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