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Less false‐negative sentinel node procedures in melanoma patients with experience and proper collaboration
Author(s) -
Veenstra Hidde J.,
Wouters Michel J.W.M.,
Kroon Bin B.R.,
Olmos Renato. A. Valdés,
Nieweg Omgo E.
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21967
Subject(s) - medicine , sentinel node , biopsy , sentinel lymph node , melanoma , false negative reactions , surgery , cohort , radiology , general surgery , cancer , breast cancer , cancer research
Background and objectives The aims of the study were to determine the percentage of false‐negative sentinel node procedures in melanoma patients, to investigate the time cohort of these recurrences, whether a learning phase was involved and to search for causes of the failures. Methods Between December 1993 and December 2008, 708 melanoma patients underwent a sentinel node biopsy. The procedure was considered false‐negative if a recurrence developed in the basin from which a tumor‐free sentinel node had been removed. Of all false‐negative cases, the pre‐operative images, operative report and pathology slides were reviewed. Results Sentinel node biopsy was positive in 164 (23%) of the patients and false‐negative in 10 (1.4%), which results in a false‐negative rate of 5.7%. Five of the 10 failures occurred in the first year after the sentinel node biopsy was introduced. Causes for these false‐negative procedures could be attributed once to the nuclear medicine physician, once to the surgeon and twice to the pathologist. Conclusion The sentinel node procedure failed to identify involvement in 5.7% of the patients with lymph node metastases. Half of the false‐negative biopsies took place in the first year after the procedure was introduced, illustrating the existence of a learning period. J. Surg. Oncol. 2011; 104:454–457. © 2011 Wiley‐Liss, Inc.