Publication date: Feb 11, 2020
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; P
Long-term follow up indicates that SLNB showcases durable accuracy, safety, and prognostic importance for cutaneous HNCM.
Hanks, J.E., Kovatch, K.J., Ali, S.A., Roberts, E., Durham, A.B., Smith, J.D., Bradford, C.R., Malloy, K.M., Boonstra, P.S., Lao, C.D., and McLean, S.A. Sentinel Lymph Node Biopsy in Head and Neck Melanoma: Long-term Outcomes, Prognostic Value, Accuracy, and Safety. 25772. 2020 Otolaryngol Head Neck Surg.
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