False negative sentinel lymph node biopsies in melanoma may result from deficiencies in nuclear medicine, surgery, or pathology

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dc.contributor.author Karim, RZ
dc.contributor.author Scolyer, RA
dc.contributor.author Li, W
dc.contributor.author Yee, VSK
dc.contributor.author McKinnon, JG
dc.contributor.author Li, L-XL
dc.contributor.author Uren, RF
dc.contributor.author Lam, S
dc.contributor.author Beavis, A
dc.contributor.author Dawson, M
dc.contributor.author Doble, P
dc.contributor.author Hoon, DSB
dc.contributor.author Thompson, JF
dc.date.accessioned 2010-05-28T09:50:43Z
dc.date.issued 2008-06
dc.identifier.citation Annals of Surgery, 2008, 247 (6), pp. 1003 - 1010
dc.identifier.issn 0003-4932
dc.identifier.other C1 en_US
dc.identifier.uri http://hdl.handle.net/10453/9605
dc.description.abstract OBJECTIVE: To investigate a cohort of melanoma patients with false negative (FN) sentinel node (SN) biopsies (SNBs) to identify the reasons for the FN result. SUMMARY OF BACKGROUND DATA: SNB is a highly efficient staging method in melanoma patients. However, with long-term follow-up FN SNB results of up to 25% have been reported. METHODS: Seventy-four SNs from 33 patients found to have had an FN SNB were analyzed by reviewing the lymphoscintigraphy, surgical data, and histopathology, and by assessing nodal tissue using multimarker real-time quantitative reverse transcription (qRT) polymerase chain reaction, and antimony concentration measurements (as a marker of "true" SN status) using inductively coupled plasma mass spectroscopy. RESULTS: Nine SNs (12%) from 9 patients (27%) had evidence of melanoma on histopathologic review. Twelve SNs (16%) from 10 patients (30%) were qRT(+). Four of these 12 SNs were positive on histopathology review and 8 were negative. Four patients (12%) were upstaged by qRT. Sixteen patients had their SNB histology, lymphoscintigraphy, and surgical data reviewed. Identifiable causes of the FN SNBs were not found after review of all modalities in 4 patients. SNs from all 4 patients had antimony levels indicative of an SN. Of the SNs evaluable by qRT, 1 was qRT(+) and 7 SNs from 2 patients were qRT(-). CONCLUSIONS: An FN SN can occur because of deficiencies in nuclear medicine, surgery, or pathology. qRT can detect "occult" metastatic melanoma in SNs that have been identified as negative by histopathology. © 2008 Lippincott Williams & Wilkins, Inc.
dc.language eng
dc.relation.isbasedon 10.1097/SLA.0b013e3181724f5e
dc.title False negative sentinel lymph node biopsies in melanoma may result from deficiencies in nuclear medicine, surgery, or pathology
dc.type Journal Article
dc.parent Annals of Surgery
dc.journal.volume 6
dc.journal.volume 247
dc.journal.number 6 en_US
dc.publocation United States en_US
dc.identifier.startpage 1003 en_US
dc.identifier.endpage 1010 en_US
dc.cauo.name SCI.Faculty of Science en_US
dc.conference Verified OK en_US
dc.for 1103 Clinical Sciences
dc.personcode 910324
dc.personcode 010494
dc.personcode 990445
dc.percentage 100 en_US
dc.classification.name Clinical Sciences en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Science
pubs.organisational-group /University of Technology Sydney/Faculty of Science/School of Chemistry and Forensic Science
pubs.organisational-group /University of Technology Sydney/Strength - Forensic Science
utslib.copyright.status Closed Access
utslib.copyright.date 2015-04-15 12:17:09.805752+10
pubs.consider-herdc true
utslib.collection.history Closed (ID: 3)


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