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JAMA Surg. 2013 May;148(5):456-61. doi: 10.1001/jamasurg.2013.1335.

Long-term follow-up and survival of patients following a recurrence of melanoma after a negative sentinel lymph node biopsy result.

Author information

1
Department of Surgery, University of Colorado Denver, Aurora, CO 80045, USA.

Abstract

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.

PMID:
23325294
PMCID:
PMC3856253
DOI:
10.1001/jamasurg.2013.1335
[Indexed for MEDLINE]
Free PMC Article
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