Predictors of false negative sentinel lymph node biopsy in trunk and extremity melanoma.
JOURNAL OF SURGICAL ONCOLOGY(2017)
摘要
BackgroundNodal recurrence following negative sentinel lymph node biopsy (SLNB) for melanoma is known as false-negative (FN) SLNB. Risk factors for FN SLNB among patients with trunk and extremity melanoma have not been well-defined. MethodsAfter retrospective review, SLNB procedures were classified FN, true positive (TP; positive SLNB), or true negative (TN; negative SLNB without recurrence). Factors associated with high false negative rate (FNR) and low negative predictive value (NPV) were identified by comparing FNs to TPs and TNs, respectively. Survival was evaluated using Kaplan-Meier methods. ResultsOf 1728 patients, 234 were TP and 37 were FN for overall FNR of 14% and NPV of 97.5%. Age 65 years was independently associated with high FNR (FNR 20% in this group). Breslow thickness >1mm and ulceration were independently associated with low NPV. Among patients with ulcerated tumors >4mm, NPV was 88%. Median time to recurrence for FNs was 13 months. Among patients with primary melanomas 2mm in depth, overall and distant disease-free survival were significantly shorter with FN SLNB than TP SLNB. ConclusionsOlder 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.
更多查看译文
关键词
biopsy,false negative,melanoma,sentinel lymph node
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络