Document Detail

Long-term follow-up and survival of patients following a recurrence of melanoma after a negative sentinel lymph node biopsy result.
MedLine Citation:
PMID:  23325294     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To analyze the predictors and patterns of recurrence of melanoma in patients with a negative sentinel lymph node biopsy result.
DESIGN: Retrospective chart review of a prospectively created database of patients with cutaneous melanoma. SETTING Tertiary university hospital.
PATIENTS: A total of 515 patients with melanoma underwent a sentinel lymph node biopsy without evidence of metastatic disease between 1996 and 2008.
MAIN OUTCOME MEASURES: Time to recurrence and overall survival.
RESULTS: Of 515 patients, 83 (16%) had a recurrence of melanoma at a median of 23 months during a median follow-up of 61 months (range, 1-154 months). Of these 83 patients, 21 had melanoma that metastasized in the studied nodal basin for an in-basin false-negative rate of 4.0%. Patients with recurrence had deeper primary lesions (mean thickness, 2.7 vs 1.8 mm; P < .01) that were more likely to be ulcerated (32.5% vs 13.5%; P < .001) than those without recurrence. The primary melanoma of patients with recurrence was more likely to be located in the head and neck region compared with all other locations combined (31.8% vs 11.7%; P < .001). Median survival following a recurrence was 21 months (range, 1-106 months). Favorable characteristics associated with lower risk of recurrence included younger age at diagnosis (mean, 49 vs 57 years) and female sex (9% vs 21% for males; P < .001).
CONCLUSION: Overall, recurrence of melanoma (16%) after a negative sentinel lymph node biopsy result was similar to that in previously reported studies with an in-basin false-negative rate of 4.0%. Lesions of the head and neck, the presence of ulceration, increasing Breslow thickness, older age, and male sex are associated with increased risk of recurrence, despite a negative sentinel lymph node biopsy result.
Edward L Jones; Teresa S Jones; Nathan W Pearlman; Dexiang Gao; Robert Stovall; Csaba Gajdos; Nicole Kounalakis; Rene Gonzalez; Karl D Lewis; William A Robinson; Martin D McCarter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JAMA surgery     Volume:  148     ISSN:  2168-6262     ISO Abbreviation:  JAMA Surg     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-16     Completed Date:  2013-08-01     Revised Date:  2013-12-17    
Medline Journal Info:
Nlm Unique ID:  101589553     Medline TA:  JAMA Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  456-61     Citation Subset:  AIM; IM    
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MeSH Terms
Disease-Free Survival
Follow-Up Studies
Melanoma / mortality*,  pathology*,  therapy
Middle Aged
Neoplasm Recurrence, Local / mortality,  pathology*,  therapy
Retrospective Studies
Sentinel Lymph Node Biopsy*
Skin Neoplasms / mortality*,  pathology*,  therapy
Survival Rate
Time Factors
Grant Support
Comment In:
JAMA Surg. 2013 May;148(5):462   [PMID:  23325337 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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