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首页> 外文期刊>Nature clinical practice. Oncology >Prognostic false-positivity of the sentinel node in melanoma.
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Prognostic false-positivity of the sentinel node in melanoma.

机译：黑色素瘤前哨淋巴结的预后假阳性。

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It is a basic tenet of the sentinel lymph-node biopsy procedure that all positive sentinel lymph nodes will inevitably progress to palpable nodal recurrence if not removed. Comparison of survival is, therefore, considered permissible among patients with positive sentinel lymph nodes who undergo early lymphadenectomy with that among patients who have delayed lymphadenectomy for palpable regional node metastasis, providing that survival is calculated from the date of wide local excision of the primary tumor. Here, that fundamental assumption is contested and evidence is presented to show that a positive sentinel lymph node might have no adverse prognostic relevance in up to one-third of patients. Furthermore, in the same patients, progression to palpable nodal disease might not have occurred even if the positive sentinel node had not been removed. The term prognostic false-positivity is used to describe this phenomenon. Such patients are incorrectly up-staged, are given inaccurate prognostic information and can undergo unnecessary completion lymphadenectomy and unnecessary adjuvant therapy.
机译：前哨淋巴结活检过程的基本原则是，如果不去除所有阳性前哨淋巴结，将不可避免地进展为明显的淋巴结复发。因此，在进行早期淋巴结清扫术的前哨淋巴结阳性的患者与因可触及的局部淋巴结转移而延迟淋巴结清扫术的患者中，生存期的比较被认为是允许的，前提是生存期应从广泛切除原发肿瘤的日期算起。在这里，对基本假设的质疑和存在的证据表明阳性哨兵淋巴结在多达三分之一的患者中可能没有不良的预后相关性。此外，在同一例患者中，即使未清除阳性前哨淋巴结，也可能未发生向明显的淋巴结转移的疾病。术语预后假阳性可用来描述这种现象。这些患者的步调错误，预后信息不准确，可以进行不必要的完全淋巴结清扫术和不必要的辅助治疗。

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