This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Caracò, C. Articles by Mozzillo, N. Search for Related Content PubMed Articles by Caracò, C. Articles by Mozzillo, N.

Impact of False-Negative Sentinel Lymph Node Biopsy on Survival in Patients with Cutaneous Melanoma

National Cancer Institute, Via M. Semmola, 80131, Naples, Italy

Correspondence: Address correspondence and reprint requests to: C. Caracò; E-mail: corracara{at}fastwebnet.it

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.

Key Words: Cutaneous melanoma • Sentinel biopsy • Lymph node metastases • False-negative

This article has been cited by other articles:

				J. A.P. Leijte, I. M.C. van der Ploeg, R. A. Valdes Olmos, O. E. Nieweg, and S. Horenblas Visualization of Tumor Blockage and Rerouting of Lymphatic Drainage in Penile Cancer Patients by Use of SPECT/CT J. Nucl. Med., March 1, 2009; 50(3): 364 - 367. [Abstract] [Full Text] [PDF]

				C. R. Rossi, S. Pasquali, and S. Mocellin Actual False-Negative Rate Prompts the Routine Use of Ultrasound Scan Before and After Sentinel Node Biopsy in Melanoma Ann. Surg. Oncol., October 1, 2008; 15(10): 2976 - 2977. [Full Text] [PDF]

				A. C. Federico, A. B. Chagpar, M. I. Ross, R. C. G. Martin, R. D. Noyes, J. S. Goydos, P. D. Beitsch, M. M. Urist, S. Ariyan, J. J. Sussman, et al. Effect of Multiple-Nodal Basin Drainage on Cutaneous Melanoma Arch Surg, July 1, 2008; 143(7): 632 - 638. [Abstract] [Full Text] [PDF]