Recurrence of cutaneous melanoma of the head and neck after negative sentinel lymph node biopsy.
BACKGROUND
Sentinel lymph node biopsy remains controversial for cutaneous melanoma of the head and neck (CMHN). Incidence and factors associated with recurrence after negative sentinel lymph node biopsy have not been well delineated.


METHODS
Characteristics of 204 patients with head and neck melanoma who had a negative sentinel lymph node biopsy were studied. Main outcomes were overall survival and disease-free survival.


RESULTS
Recurrence developed in 45 patients (22%) with a median time to recurrence of 20.1 months. Five-year overall survival was 91.8% for patients without recurrence and 57.0% for those with recurrence. The overall regional recurrence rate was 8.8% (n = 18) and was associated with Breslow thickness >2 mm and scalp location of the primary tumor. The false omission rate was 3.4%.


CONCLUSIONS
For CMHN, regional recurrence after negative sentinel lymph node biopsy occurs at acceptably low rates relative to other sites, although it is associated with adverse survival.
Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
Melinda V
MV
Davis-Malesevich
Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, California.
Ryan
R
Goepfert
Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, Texas.
Mark
M
Kubik
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Dianna B
DB
Roberts
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jeffrey N
JN
Myers
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Michael E
ME
Kupferman
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D062109:Dermatologic Surgical Procedures / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
cutaneous melanoma; false-negative sentinel lymph node biopsy; head and neck melanoma; melanoma; melanoma recurrence; sentinel lymph node biopsy