Negative Sentinel Lymph Node XXXX is Associated with a Low Risk of Same-Nodal-Basin Recurrences.

@entity1 @entity3852 @entity204
BACKGROUND: Controversy exists regarding the predictive ability of a negative sentinel lymph node biopsy (SLNB) and the use of adjuvant radiation in @entity3852 ( @entity3852 ). METHODS: Retrospective study of @entity1 with @entity3852 undergoing SLNB at Mayo Clinic from 1995 to 2011. Cumulative incidence (CI) of regional recurrence and @entity204 from @entity3852 , respectively, were estimated taking into account the competing risk of @entity204 from other causes and compared between groups using Gray's test. RESULTS: A total of 111 (74  %) of 150 SLNB were negative and comprised our study group. There were 15 regional recurrences, and the CI of a regional recurrence was 5.1, 15.0, and 16.6  % at 1, 3, and 5  years, respectively, after initial surgery. Nine @entity1 (8  % of all @entity1 ) experienced a same nodal basin recurrence after a negative SLNB. Among 14 @entity1 who received nodal radiation, the CI of a regional recurrence was 0 and 9.1  % at 1 and 3  years, respectively, compared to 5.8 and 15.5  %, respectively, among the 97 who did not receive nodal radiation (p  =  0.45). Male sex was the only characteristic predictive of regional recurrence after a negative SLNB; the CI at 3  years was 21.3 versus 0  % in @entity1 and @entity1 , respectively (p  =  0.007). Head and neck location was not associated with a higher risk of recurrence or an improvement in regional recurrences after radiation. CONCLUSIONS: Same nodal basin recurrences are uncommon after SLNB in @entity3852 , and regional nodal irradiation can be avoided in the setting of successful sentinel lymph node mapping and a negative SLNB.
