False-negative sentinel lymph node biopsy for melanoma: a single-surgeon experience

• Published in: Canadian Journal of Surgery Vol. 67; no. 5; pp. E337 - E344
• Main Authors: Downey, Julia, DeVries, Kimberly, Lano, Ian Marie, Baliski, Christopher
• Format: Journal Article
• Language: English
• Published: Canada CMA Impact, Inc 27.09.2024; CMA Impact Inc
• Subjects: Adjuvants; Adult; Aged; Aged, 80 and over; Biopsy; Cancer therapies; Cohort analysis; False Negative Reactions; Female; Humans; Immunotherapy; Information systems; Lymphatic Metastasis; Lymphatic system; Male; Melanoma; Melanoma - pathology; Melanoma - surgery; Middle Aged; Neoplasm Recurrence, Local - pathology; Oncology; Patients; Retrospective Studies; Sentinel Lymph Node Biopsy - statistics & numerical data; Skin Neoplasms - pathology; Skin Neoplasms - surgery; Surgeons; Surveillance; Variables
• ISSN: 0008-428X; 1488-2310; 1488-2310
• DOI: 10.1503/cjs.016023

The status of the regional lymph node basin is of prognostic importance in patients with melanoma, making the performance of sentinel lymph node biopsies (SLNBs) a key component of patient care management, particularly with the advent of immunotherapy for adjuvant treatment. The primary goal of our study was to assess the false-negative rate of SLNBs among patients with melanoma. We conducted a retrospective review of patients with melanoma undergoing SLNB by a single surgeon between Jan. 1, 2005, and Dec. 31, 2020. We extracted and cross-referenced patient demographic and pathologic information. During the study period, 501 patients underwent an SLNB. Of these, 97 (19.4%) patients had pathologically positive sentinel lymph nodes and 404 (80.6%) patients had negative results. The latter were subject to further review; 84 (20.8%) patients subsequently developed recurrence, with 25 (6.2%) recurrences within the primary nodal basin. Isolated regional recurrence occurred in 11 (2.7%) patients and conjunction with a false-negative rate was 10.2%. Unadjusted recurrence rates were similar across each lymph node basin, including the axilla (2.7%), groin (3.6%), and neck (1.4%). The false-negative SLNB rate was 10.2% for isolated regional recurrences. These findings need to be considered in the era of using adjuvant systemic therapy for patients with melanoma.