Abstract
Up to 30% of sentinel node-negative patients develop metastases during follow-up. Negative sentinel node biopsies (SNB) can be classified to false (FN) and true negative (TN) categories. Little attention has been paid to the characteristics and outcomes of patients who experience direct distant metastasis following TN-SNB. In this retrospective study of a melanoma database at Tampere university hospital we analyzed characteristics and outcome following metastases after TN-SNB. A total of 506 patients underwent SNB between 2006 and 2016. After review, SNBs were classified FN, TN and true positive (TP). Follow-up was performed until 30.4.2019.
Highlights
The standard treatment of melanoma is wide local excision of primary tumor and sentinel node biopsy (SNB) for staging purposes [1]
The value of SNB as a prognostic marker may be reduced by the existence of false negative results or distant recurrence after negative SNB
Negative SNBs were divided to false negative (FN), true negative (TN) with distant metastasis (TND), TN without recurrence (TN-NoR) and negative SNB with local recurrence (LR)
Summary
The standard treatment of melanoma is wide local excision of primary tumor and sentinel node biopsy (SNB) for staging purposes [1]. The utility of SNB correlates with depth of invasion of the primary tumor, and is a routine management in patients with melanoma thicker than 1 mm and may be considered for thin lesions with high-risk characteristics (e.g. ulceration) [2]. The value of SNB as a prognostic marker may be reduced by the existence of false negative results or distant recurrence after negative SNB. The probability of developing distant or local recurrence following a negative SNB during follow-up ranges from 4% to 29% [4]. A FN-SNB has been defined as a recurrence of melanoma in the previously biopsied lymph node basin [4]. The presence of multiple SN basins and regions of the body where lymphatic drainage is known to be complex (head/neck)
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