Value of frozen-section analysis of sentinel lymph nodes for primary cutaneous malignant melanoma Journal Article

Authors: Stojadinovic, A.; Allen, P. J.; Clary, B. M.; Busam, K. J.; Coit, D. G.
Article Title: Value of frozen-section analysis of sentinel lymph nodes for primary cutaneous malignant melanoma
Abstract: Objective: To analyze a large, single-institution experience with routine frozen section (FS) of the sentinel lymph node (SLN) in patients with primary cutaneous melanoma. Summary Background Data: Controversy exists over the utility of intraoperative FS analysis of the SLN in patients with primary cutaneous melanoma. Methods: All patients with clinically node-negative cutaneous melanoma undergoing SLN biopsy from 1991 to 1999 were identified from a prospective database. All SLNs were examined by FS. Step-sectioning and immunohistochemistry of permanent section were performed for SLNs negative by FS. Results: At least one SLN was identified in 98% (360/368) of patients. There were 74 (20%) SLNs positive on permanent section; FS was positive in 59% of these. The accuracy, sensitivity, and specificity of FS were 92%, 59%, and 100%. Because isolated recurrence developed in six patients in the nodal basin in which the SLN was negative, the failure rate was 1.7%. The false-negative rate for SLN biopsy was 7.5%. Conclusions: Because the prevalence of metastases within the SLN and sensitivity of FS analysis are low, routine use of FS for all patients undergoing SLN biopsy is not recommended.
Keywords: immunohistochemistry; adolescent; adult; child; controlled study; human tissue; aged; aged, 80 and over; middle aged; major clinical study; follow-up studies; lymphatic metastasis; prospective study; sensitivity and specificity; sentinel lymph node; lymph node excision; prospective studies; sentinel lymph node biopsy; treatment indication; accuracy; melanoma; skin neoplasms; time factors; data interpretation, statistical; reliability; frozen section; frozen sections; lymph node biopsy; humans; prognosis; human; male; female; priority journal; article
Journal Title: Annals of Surgery
Volume: 235
Issue: 1
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2002-01-01
Start Page: 92
End Page: 98
Language: English
DOI: 10.1097/00000658-200201000-00012
PUBMED: 11753047
PROVIDER: scopus
PMCID: PMC1422400
Notes: Export Date: 14 November 2014 -- Source: Scopus
Citation Impact
MSK Authors
  1. Peter Allen
    493 Allen
  2. Daniel Coit
    498 Coit
  3. Klaus J Busam
    599 Busam
  4. Bryan M Clary
    7 Clary