Utility of frozen-section analysis of sentinel lymph node biopsy specimens for melanoma in surgical decision making.
BACKGROUND
Debate exists whether frozen-section analysis of sentinel lymph nodes (SLNs) for melanoma is an accurate method to detect disease that has metastasized to the lymph nodes. The purpose of this study was to evaluate the utility of intraoperative frozen section for SLNs in melanoma.


METHODS
We reviewed 133 patients (271 nodes) who underwent SLN biopsy with frozen section for melanoma between April 2003 and September 2007. Frozen-section diagnosis was compared with final diagnosis to determine concordance between intraoperative and postsurgical diagnosis.


RESULTS
A total of 11 nodes (8% of patients) were found to have metastatic disease. All patients underwent lymph node dissections at the time of SLN biopsy. No false-positive SLNs were found on frozen section. The false-negative rate for SLN biopsy frozen section was 8% (1 of 133 patients).


CONCLUSIONS
Intraoperative frozen section can be an accurate and reliable tool in the right setting for analysis of sentinel nodes in cutaneous melanoma and deserves further study.
Alkhatib
Weesam
W
Department of Surgery, University of Kansas, Medical Center, Kansas City, KS 66160, USA.
Hertzenberg
Casey
C
Jewell
William
W
Al-Kasspooles
Mazin F
MF
Damjanov
Ivan
I
Cohen
Mark S
MS
D003657:Decision Making; D003937:Diagnosis, Differential; D005260:Female; D005629:Frozen Sections / Q000706:statistics & numerical data*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data*; D012878:Skin Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery