Predictors of false negative sentinel lymph node biopsy in trunk and extremity melanoma

Abstract

Older age is associated with increased FNR; patients with thick, ulcerated lesions should be considered for increased nodal surveillance after negative SLNB given low NPV in this group.

Current management of regional lymph nodes in patients with melanoma

“…3,4 These factors are associated both with increased false-negative SLN biopsy rates as well as risk of recurrence and death from disease. 5 I agree with Dr Ciancio et al that head and neck primaries require specific, thoughtful consideration for all of these reasons. I would propose, however, that disease-free survival should not be our primary outcome of interest.…”

“…Furthermore, head and neck primaries are more frequently ulcerated, thicker, and tend to occur in older, male patients . These factors are associated both with increased false‐negative SLN biopsy rates as well as risk of recurrence and death from disease …”

Does the number of sentinel lymph nodes removed affect the false negative rate for head and neck melanoma?

“…Several factors have been reported to increase the FNR in melanoma. For example, older age, thicker tumors, ulcerated tumors, local/in‐transit recurrence, and male gender . Furthermore, HN melanoma has been reported to have a higher FNR compared to other melanoma locations .…”

Predictors of Metastasis and Outcome Following True Negative Sentinel Node Biopsy

“…Unexpected or aberrant lymph drainage patterns are expected in head and neck melanomas more than melanomas located on upper and lower extremity [10]. This supports more routine use of SPECT-CT in this population [7]. We An association between NM and melanoma recurrence has been described in SN-negative patients [10].…”

“…The other major issue examined in this study is the impact of TN-D on outcome. The prior research has primarily attempted to identify clinical factors associated with the occurrence of FN-SNB and the impact of FN-SNB on survival outcome[4,6,7,8]. are SNB-negative.…”