Intraoperative sentinel lymph node analysis in melanoma

Background The objective of this retrospective cohort study was to evaluate the sensitivity and specificity of touch preparation cytology (TPC) and frozen section (FS) histology in the intraoperative staging of melanoma. Methods The cohort was identified from all patients with clinically node negati...

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Published in:Journal of surgical oncology 2011-01, Vol.103 (1), p.1-5
Main Authors: Badgwell, Brian D., Pierce, Charles, Broadwater, J. Ralph, Westbrook, Kent, Korourian, Soheila, Davis, Dan, Hiatt, Kim, Lee, Jeannette, Cheung, Wang L., Klimberg, V. Suzanne
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Female
frozen section
Frozen Sections
Humans
Intraoperative Period
Lymph Nodes - pathology
Lymphatic Metastasis
Male
melanoma
Melanoma - secondary
Melanoma - surgery
Middle Aged
Neoplasm Staging
Retrospective Studies
Sensitivity and Specificity
Sentinel Lymph Node Biopsy
Skin Neoplasms - pathology
Skin Neoplasms - surgery
touch prep
Young Adult
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Summary:Background The objective of this retrospective cohort study was to evaluate the sensitivity and specificity of touch preparation cytology (TPC) and frozen section (FS) histology in the intraoperative staging of melanoma. Methods The cohort was identified from all patients with clinically node negative melanoma undergoing a SLN biopsy using Technetium and/or blue dye mapping from 1/1998 to 10/2008. TPC and FS analysis was performed utilizing Diff‐quick and compared to permanent section interpretation with H&E. Results Of 271 patients undergoing SLN biopsy, 163 underwent intraoperative analysis of the sentinel node (125 underwent TPC alone, 15 underwent FS alone, 23 underwent both TPC and FS), and 108 underwent no intraoperative analysis. Thirty‐three patients undergoing intraoperative analysis of the SLN were found to have positive nodes (20%) on permanent histology. There were no false positives identified (specificity = 100%). The overall sensitivity for all methods of intraoperative analysis was 61% (20/33). On a per patient basis, the sensitivity was 47% (9/19) for TPC alone, 75% (3/4) for FS alone, and 80% (8/10) for both TPC and FS. Conclusions There were no false positives identified suggesting TPC and FS can be used safely to identify the majority of SLN that harbor metastases from melanoma. J. Surg. Oncol. 2011;103:1–5. © 2010 Wiley‐Liss, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.21757