TY - JOUR
T1 - Reliability of the sentinel node procedure in melanoma patients
T2 - Analysis of failures after long-term follow-up
AU - Statius Muller, Markwin G.
AU - Borgstein, Paul J.
AU - Pijpers, Rik
AU - Van Leeuwen, Paul A M
AU - Van Diest, Paul J.
AU - Gupta, Anurag
AU - Meijer, Sybren
PY - 2000/7
Y1 - 2000/7
N2 - Background: The sentinel node (SN) concept assumes that early lymphatic metastases, if present, always are found first in the SN. The aim of this study was to determine the reliability of this procedure by establishing the success rate and number of failed procedures during a follow-up period of at least 2 years. Methods: From August 1993 to November 1996, 204 consecutive patients with stage I and II cutaneous melanoma underwent SN biopsy by a triple technique. Preoperatively, all patients underwent (dynamic) lymphoscintigraphy. A gamma probe and blue dye helped localize the SN(s) during surgery, and these nodes subsequently were excised. These lymph nodes were step-sectioned and examined by routine and immunohistochemical staining. If the SN contained tumor cells, a lymphadenectomy was performed at a later date. Results: The median follow-up time was 42 months. The success rate was 99%. Three patients developed a recurrence in the negative SN basin during follow-up, without simultaneous appearance of (locoregional) metastases. Conclusions: With a 99% success rate and a 1.5% rate of failed SN procedures (7% false-negative rate) after a median follow-up of 3.5 years, we concluded that the combined triple technique approach of detecting the SN was a reliable method to accurately identify and retrieve the SN.
AB - Background: The sentinel node (SN) concept assumes that early lymphatic metastases, if present, always are found first in the SN. The aim of this study was to determine the reliability of this procedure by establishing the success rate and number of failed procedures during a follow-up period of at least 2 years. Methods: From August 1993 to November 1996, 204 consecutive patients with stage I and II cutaneous melanoma underwent SN biopsy by a triple technique. Preoperatively, all patients underwent (dynamic) lymphoscintigraphy. A gamma probe and blue dye helped localize the SN(s) during surgery, and these nodes subsequently were excised. These lymph nodes were step-sectioned and examined by routine and immunohistochemical staining. If the SN contained tumor cells, a lymphadenectomy was performed at a later date. Results: The median follow-up time was 42 months. The success rate was 99%. Three patients developed a recurrence in the negative SN basin during follow-up, without simultaneous appearance of (locoregional) metastases. Conclusions: With a 99% success rate and a 1.5% rate of failed SN procedures (7% false-negative rate) after a median follow-up of 3.5 years, we concluded that the combined triple technique approach of detecting the SN was a reliable method to accurately identify and retrieve the SN.
KW - False-negative
KW - Follow-up
KW - Locoregional lymph basin recurrence
KW - Melanoma
KW - Sentinel node procedure
KW - Success rate
UR - http://www.scopus.com/inward/record.url?scp=0007747103&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0007747103&partnerID=8YFLogxK
M3 - Article
C2 - 10894143
AN - SCOPUS:0007747103
SN - 1068-9265
VL - 7
SP - 461
EP - 468
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 6
ER -