Journal article
Sentinel Lymph Node Biopsy in Head and Neck Melanoma: Long-term Outcomes, Prognostic Value, Accuracy, and Safety
Otolaryngology-head and neck surgery, Vol.162(4), pp.520-529
04/2020
DOI: 10.1177/0194599819899934
PMCID: PMC8012010
PMID: 32041486
Abstract
To evaluate the long-term outcomes of sentinel lymph node biopsy (SLNB) for head and neck cutaneous melanoma (HNCM).
Retrospective cohort study.
Tertiary academic medical center.
Longitudinal review of a 356-patient cohort with HNCM undergoing SLNB from 1997 to 2007.
Descriptive characteristics included the following: age, 53.5 ± 19 years (mean ± SD); sex, 26.8% female; median follow-up, 4.9 years; and Breslow depth, 2.52 ± 1.87 mm. Overall, 75 (21.1%) patients had a positive SLNB. Among patients undergoing completion lymph node dissection following positive SLNB, 20 (27.4%) had at least 1 additional positive nonsentinel lymph node. Eighteen patients with local control and negative SLNB developed regional disease, indicating a false omission rate of 6.4%, including 10 recurrences in previously unsampled basins. Ten-year overall survival (OS) and melanoma-specific survival (MSS) were significantly greater in the negative sentinel lymph node (SLN) cohort (OS, 61% [95% CI, 0.549-0.677]; MSS, 81.9% [95% CI, 0.769-0.873]) than the positive SLN cohort (OS, 31% [95% CI, 0.162-0.677]; MSS, 60.3% [95% CI, 0.464-0.785]) and positive SLN/positive nonsentinel lymph node cohort (OS, 8.4% [95% CI, 0.015-0.474]; MSS, 9.6% [95% CI, 0.017-0.536]). OS was significantly associated with SLN positivity (hazard ratio [HR], 2.39;
< .01), immunosuppression (HR, 2.37;
< .01), angiolymphatic invasion (HR, 1.91;
< .01), and ulceration (HR, 1.86;
< .01). SLN positivity (HR, 3.13;
< .01), angiolymphatic invasion (HR, 3.19;
< .01), and number of mitoses (
= .0002) were significantly associated with MSS. Immunosuppression (HR, 3.01;
< .01) and SLN status (HR, 2.84;
< .01) were associated with recurrence-free survival, and immunosuppression was the only factor significantly associated with regional recurrence (HR, 6.59;
< .01).
Long-term follow up indicates that SLNB showcases durable accuracy, safety, and prognostic importance for cutaneous HNCM.
Details
- Title: Subtitle
- Sentinel Lymph Node Biopsy in Head and Neck Melanoma: Long-term Outcomes, Prognostic Value, Accuracy, and Safety
- Creators
- John E Hanks - Michigan MedicineKevin J Kovatch - Michigan MedicineS Ahmed Ali - Michigan MedicineEmily Roberts - University of MichiganAlison B Durham - Michigan MedicineJoshua D Smith - Michigan MedicineCarol R Bradford - University of MichiganKelly M Malloy - Michigan MedicinePhilip S Boonstra - University of MichiganChristopher D Lao - Michigan MedicineScott A McLean - Michigan Medicine
- Resource Type
- Journal article
- Publication Details
- Otolaryngology-head and neck surgery, Vol.162(4), pp.520-529
- DOI
- 10.1177/0194599819899934
- PMID
- 32041486
- PMCID
- PMC8012010
- NLM abbreviation
- Otolaryngol Head Neck Surg
- ISSN
- 0194-5998
- eISSN
- 1097-6817
- Grant note
- T32 DC005356 / NIDCD NIH HHS P30 CA046592 / NCI NIH HHS
- Language
- English
- Date published
- 04/2020
- Academic Unit
- Biostatistics
- Record Identifier
- 9984274822202771
Metrics
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