title: False-negative sentinel lymph node biopsy in head and neck melanoma.
abstract: OBJECTIVE
  The results of sentinel lymph node biopsy (SLNB) can be useful for staging and deciding on adjuvant treatment for patients with head and neck melanoma. False-negative SLNB can result in treatment delay. This study aimed to evaluate the characteristics and outcome of patients with false-negative SLNB in cutaneous melanoma of the head and neck.
  
  
  METHODS
  Longitudinal cohort study using a prospective institutional tumor registry.
  
  
  METHODS
  Academic health center.
  
  
  METHODS
  Data from 153 patients who underwent SLNB for melanoma of the head and neck were analyzed. False-negative biopsy was defined as recurrence of tumor in a previously identified negative nodal basin. Statistical analysis was performed on registry data.
  
  
  RESULTS
  Positive sentinel lymph nodes were identified in 19 (12.4%) patients. False-negative SLNB was noted in 9 (5.9%) patients, with a false-negative SLNB rate of 32.1%. Using multivariate regression analysis, only examination of a single sentinel lymph node was a significant predictor of false-negative SLNB (P = .01). The mean treatment delay for the false-negative SLNB group was 470 days compared with 23 days in the positive SLNB group (P < .001). The 2-year overall survival of patients with false-negative SLNB was 75% compared with 84% and 98% in positive and negative SLNB groups, respectively (P = .02).
  
  
  CONCLUSIONS
  False-negative SLNB is more likely to occur when a single sentinel lymph node is harvested. There is significant treatment delay in patients with false-negative SLNB. False-negative SLNB is associated with poor outcome in patients with melanoma of the head and neck.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon 97239, USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Miller
authors.forename: John T
authors.initials: JT
authors.lastname: Vetto
authors.forename: Marcus M
authors.initials: MM
authors.lastname: Monroe
authors.forename: Roshanthi
authors.initials: R
authors.lastname: Weerasinghe
authors.forename: Peter E
authors.initials: PE
authors.lastname: Andersen
authors.forename: Neil D
authors.initials: ND
authors.lastname: Gross
mesh_terms: D000368:Aged; D004428:Ear Neoplasms / Q000473:pathology; D005153:Facial Neoplasms / Q000473:pathology; D005188:False Negative Reactions; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D012535:Scalp; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology