OBJECTIVE: To report the long-term significance of sentinel lymph node (SLN) biopsy on prognosis, determine false-negative SLN occurrences, and determine risk factors for death and recurrence in a large series of patients with head and neck melanoma. STUDY DESIGN: Case series with tumor registry review. SETTING: Academic tertiary care medical center. SUBJECTS AND METHODS: A database review was performed of all patients who underwent SLN biopsy for head and neck melanoma from 1994 to 2009. End points assessed were SLN status, recurrence, false-negative SLN results, and survival comparing SLN-positive and SLN-negative patients and different locations. Survival curves and multivariate analyses were performed. RESULTS: SLN biopsy was performed in 365 patients. SLNs were identified in 98.6% of patients with a mean of 3.7 nodes removed from 1.6 nodal basins per patient. Median follow-up was 8 years. The SLN was positive in 40 (11%) patients. SLN-positive patients had significantly thicker melanomas, higher recurrence (P < .0001), and a significant decrease in overall survival compared with SLN-negative patients (P < .002). Scalp melanoma patients had significantly thicker melanomas and an elevated risk of SLN positivity, recurrence, and death compared with other sites. Seventeen of 365 SLN-negative patients developed regional nodal disease for a false-omission rate of 5.2% and a negative predictive value of a negative SLN to be 94.8%. Risks for false negative-SLN occurrences included thick melanomas and scalp melanomas. CONCLUSION: SLN biopsy is accurate in head and neck melanoma and provides significant prognostic data. Scalp melanoma patients present with thicker tumors with an increase in SLN positivity and false-negative SLN occurrences.
OBJECTIVE: To report the long-term significance of sentinel lymph node (SLN) biopsy on prognosis, determine false-negative SLN occurrences, and determine risk factors for death and recurrence in a large series of patients with head and neck melanoma. STUDY DESIGN: Case series with tumor registry review. SETTING: Academic tertiary care medical center. SUBJECTS AND METHODS: A database review was performed of all patients who underwent SLN biopsy for head and neck melanoma from 1994 to 2009. End points assessed were SLN status, recurrence, false-negative SLN results, and survival comparing SLN-positive and SLN-negative patients and different locations. Survival curves and multivariate analyses were performed. RESULTS: SLN biopsy was performed in 365 patients. SLNs were identified in 98.6% of patients with a mean of 3.7 nodes removed from 1.6 nodal basins per patient. Median follow-up was 8 years. The SLN was positive in 40 (11%) patients. SLN-positive patients had significantly thicker melanomas, higher recurrence (P < .0001), and a significant decrease in overall survival compared with SLN-negative patients (P < .002). Scalp melanomapatients had significantly thicker melanomas and an elevated risk of SLN positivity, recurrence, and death compared with other sites. Seventeen of 365 SLN-negative patients developed regional nodal disease for a false-omission rate of 5.2% and a negative predictive value of a negative SLN to be 94.8%. Risks for false negative-SLN occurrences included thick melanomas and scalp melanomas. CONCLUSION: SLN biopsy is accurate in head and neck melanoma and provides significant prognostic data. Scalp melanomapatients present with thicker tumors with an increase in SLN positivity and false-negative SLN occurrences.
Authors: Frederick O Cope; Bonnie Abbruzzese; James Sanders; Wendy Metz; Kristyn Sturms; David Ralph; Michael Blue; Jane Zhang; Paige Bracci; Wiam Bshara; Spencer Behr; Toby Maurer; Kenneth Williams; Joshua Walker; Allison Beverly; Brooke Blay; Anirudh Damughatla; Mark Larsen; Courtney Mountain; Erin Neylon; Kaeli Parcel; Kapil Raghuraman; Kevin Ricks; Lucas Rose; Akhilesh Sivakumar; Nicholas Streck; Bryan Wang; Christopher Wasco; Larry S Schlesinger; Abul Azad; Murugesan V S Rajaram; Wael Jarjour; Nicholas Young; Thomas Rosol; Amifred Williams; Michael McGrath Journal: Nucl Med Biol Date: 2015-12-03 Impact factor: 2.408
Authors: Kristen A Echanique; Shabnam Ghazizadeh; Andy Moon; Kera Kwan; Peter A Pellionisz; Dennis Rünger; David Elashoff; Maie St John Journal: Laryngoscope Investig Otolaryngol Date: 2021-06-21
Authors: Dale Han; Jonathan S Zager; Daohai Yu; Xiuhua Zhao; Brooke Walls; Suroosh S Marzban; Nikhil G Rao; Vernon K Sondak; Jane L Messina Journal: Ann Surg Oncol Date: 2013-02-07 Impact factor: 5.344
Authors: John E Hanks; Kevin J Kovatch; S Ahmed Ali; Emily Roberts; Alison B Durham; Joshua D Smith; Carol R Bradford; Kelly M Malloy; Philip S Boonstra; Christopher D Lao; Scott A McLean Journal: Otolaryngol Head Neck Surg Date: 2020-02-11 Impact factor: 3.497