Details

Autor(en) / Beteiligte

• Straker, Richard J.
• Carr, Michael J.
• Sinnamon, Andrew J.
• Shannon, Adrienne B.
• Sun, James
• Landa, Karenia
• Baecher, Kirsten M.
• Wood, Christian
• Lynch, Kevin
• Bartels, Harrison G.
• Panchaud, Robyn
• Lowe, Michael C.
• Slingluff, Craig L.
• Jameson, Mark J.
• Tsai, Kenneth
• Faries, Mark B.
• Beasley, Georgia M.
• Sondak, Vernon
• Karakousis, Giorgos C.
• Zager, Jonathan S.
• Miura, John T.

Titel

Predictors of False Negative Sentinel Lymph Node Biopsy in Clinically Localized Merkel Cell Carcinoma

Ist Teil von

• Annals of surgical oncology, 2021-11, Vol.28 (12), p.6995-7003

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2021

Link zum Volltext

Quelle

SpringerLink

Beschreibungen/Notizen

• Background Sentinel lymph node biopsy (SLNB) is routinely recommended for clinically localized Merkel cell carcinoma (MCC); however, predictors of false negative (FN) SLNB are undefined. Methods Patients from six centers undergoing wide excision and SLNB for stage I/II MCC (2005–2020) were identified and were classified as having either a true positive (TP), true negative (TN) or FN SLNB. Predictors of FN SLNB were identified and survival outcomes were estimated. Results Of 525 patients, 28 (5.4%), 329 (62.7%), and 168 (32%) were classified as FN, TN, and TP, respectively, giving an FN rate of 14.3% and negative predictive value of 92.2% for SLNB. Median follow-up for SLNB-negative patients was 27 months, and median time to nodal recurrence for FN patients was 7 months. Male sex (hazard ratio [HR] 3.15, p  = 0.034) and lymphovascular invasion (LVI) (HR 2.22, p  = 0.048) significantly correlated with FN, and increasing age trended toward significance (HR 1.04, p  = 0.067). The 3-year regional nodal recurrence-free survival for males >75 years with LVI was 78.5% versus 97.4% for females ≤75 years without LVI ( p  = 0.009). Five-year disease-specific survival (90.9% TN vs. 51.3% FN, p  < 0.001) and overall survival (69.9% TN vs. 48.1% FN, p  = 0.035) were significantly worse for FN patients. Conclusion Failure to detect regional nodal microscopic disease by SLNB is associated with worse survival in clinically localized MCC. Males, patients >75 years, and those with LVI may be at increased risk for FN SLNB. Consideration of increased nodal surveillance following negative SLNB in these high-risk patients may aid in early identification of regional nodal recurrences.