Sentinel lymph node biopsy: is it possible to reduce false negative rates by excluding patients with nodular melanoma?

Hdl Handle:
http://hdl.handle.net/10147/208839
Title:
Sentinel lymph node biopsy: is it possible to reduce false negative rates by excluding patients with nodular melanoma?
Authors:
Corrigan, M A; Coffey, J C; O'Sullivan, M J; Fogarty, K M; Redmond, H P
Affiliation:
Department of Academic Surgery, Cork University Hospital, Ireland., mark@surgent.ie
Citation:
Surgeon. 2006 Jun;4(3):153-7.
Journal:
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/208839
PubMed ID:
16764200
Abstract:
OBJECTIVE: The aim of this study was to review the outcome of sentinel lymph node biopsy (SLNB) in patients with melanoma and to delineate whether patients with nodular melanoma are more likely to develop nodal recurrence despite negative SLNB. METHODS: Consecutive patients with cutaneous melanoma undergoing SLNB were identified from a departmental database between 1997 and 2005. Factors including demographic data, site, histological subtype, depth and outcome were examined. RESULTS: Of 131 patients, 103 were node negative and eligible for study. The median age was 53 (16-82) years with 46 patients being male (45%) and 57 female (55%). Primary melanoma sites included lower limb (49; 48%), upper limb (29; 28%), head (12; 11%), trunk (7; 7%) and back (6; 6%). The median Breslow thickness was 2mm. Superficial spreading accounted for 43% of melanoma with nodular accounting for 42%. Median follow-up was 40 (3-90) months. Of 20 relapses, seven recurred in the same nodal basin, three were satellite recurrences, one recurred with both satellite and nodal lesions simultaneously, and nine experienced haematogenous spread. Of the eight patients who developed recurrence in the same nodal basin, four were of nodular histological subtype (p=NS). All of the three patients with satellite lesions had nodular melanoma histologically (p=0.02). When nodal and satellite recurrences were combined, eight of 11 were histologically nodular (p=0.01). CONCLUSIONS: This study indicates that lymphatic recurrence occurs more often in SLNB negative patients with nodular melanoma. Further evaluation of the inclusion criteria for sentinel node biopsy is warranted.
Language:
eng
MeSH:
Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; False Negative Reactions; Female; Humans; Lymphatic Metastasis; Male; Melanoma/*secondary; Middle Aged; Neoplasm Recurrence, Local/*pathology; *Sentinel Lymph Node Biopsy; Skin Neoplasms/*pathology
ISSN:
1479-666X (Print); 1479-666X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorCorrigan, M Aen_GB
dc.contributor.authorCoffey, J Cen_GB
dc.contributor.authorO'Sullivan, M Jen_GB
dc.contributor.authorFogarty, K Men_GB
dc.contributor.authorRedmond, H Pen_GB
dc.date.accessioned2012-02-03T15:05:03Z-
dc.date.available2012-02-03T15:05:03Z-
dc.date.issued2012-02-03T15:05:03Z-
dc.identifier.citationSurgeon. 2006 Jun;4(3):153-7.en_GB
dc.identifier.issn1479-666X (Print)en_GB
dc.identifier.issn1479-666X (Linking)en_GB
dc.identifier.pmid16764200en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208839-
dc.description.abstractOBJECTIVE: The aim of this study was to review the outcome of sentinel lymph node biopsy (SLNB) in patients with melanoma and to delineate whether patients with nodular melanoma are more likely to develop nodal recurrence despite negative SLNB. METHODS: Consecutive patients with cutaneous melanoma undergoing SLNB were identified from a departmental database between 1997 and 2005. Factors including demographic data, site, histological subtype, depth and outcome were examined. RESULTS: Of 131 patients, 103 were node negative and eligible for study. The median age was 53 (16-82) years with 46 patients being male (45%) and 57 female (55%). Primary melanoma sites included lower limb (49; 48%), upper limb (29; 28%), head (12; 11%), trunk (7; 7%) and back (6; 6%). The median Breslow thickness was 2mm. Superficial spreading accounted for 43% of melanoma with nodular accounting for 42%. Median follow-up was 40 (3-90) months. Of 20 relapses, seven recurred in the same nodal basin, three were satellite recurrences, one recurred with both satellite and nodal lesions simultaneously, and nine experienced haematogenous spread. Of the eight patients who developed recurrence in the same nodal basin, four were of nodular histological subtype (p=NS). All of the three patients with satellite lesions had nodular melanoma histologically (p=0.02). When nodal and satellite recurrences were combined, eight of 11 were histologically nodular (p=0.01). CONCLUSIONS: This study indicates that lymphatic recurrence occurs more often in SLNB negative patients with nodular melanoma. Further evaluation of the inclusion criteria for sentinel node biopsy is warranted.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshCohort Studiesen_GB
dc.subject.meshFalse Negative Reactionsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLymphatic Metastasisen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMelanoma/*secondaryen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshNeoplasm Recurrence, Local/*pathologyen_GB
dc.subject.mesh*Sentinel Lymph Node Biopsyen_GB
dc.subject.meshSkin Neoplasms/*pathologyen_GB
dc.titleSentinel lymph node biopsy: is it possible to reduce false negative rates by excluding patients with nodular melanoma?en_GB
dc.contributor.departmentDepartment of Academic Surgery, Cork University Hospital, Ireland., mark@surgent.ieen_GB
dc.identifier.journalThe surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Irelanden_GB
dc.description.provinceMunster-

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