Document Detail


Sentinel lymph node excision and PET-CT in the initial stage of malignant melanoma: a retrospective analysis of 61 patients with malignant melanoma in American Joint Committee on Cancer stages I and II.
MedLine Citation:
PMID:  20187901     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Sentinel lymph node excision (SLNE) for the detection of regional nodal metastases and staging of malignant melanoma has resulted in some controversies in international discussions. Positron emission tomography with computerized tomography (PET-CT), a noninvasive imaging procedure for the detection of regional nodal metastases, has increasingly become of interest. Our study is a direct comparison of SLNE and PET-CT in patients with early-stage malignant melanoma.
MATERIALS AND METHODS: We retrospectively analyzed data from 61 patients with primary malignant melanoma with a Breslow index greater than 1.0 mm.
RESULTS: Metastatic SLNs were found in 14 patients (23%); 17 metastatic lymph nodes were detected overall, only one of which was identified preoperatively using PET-CT. Thus, PET-CT showed a sensitivity of 5.9% and a negative predictive value of 78%.
CONCLUSION: SLNE is much more sensitive than PET-CT in discovering small lymph node metastases. We consider PET-CT unsuitable for the evaluation of early regional lymphatic tumor dissemination in this patient population and recommend that it be limited to malignant melanomas of American Joint Committee on Cancer stages III and IV. We therefore recommend the routine use of SLNE for tumor staging and stratification for adjuvant therapy of patients with stage I and II malignant melanoma.
Authors:
Joachim Klode; Joachim Dissemond; Stephan Grabbe; Uwe Hillen; Thorsten Poeppel; Carsten Boeing
Publication Detail:
Type:  Journal Article     Date:  2010-02-19
Journal Detail:
Title:  Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]     Volume:  36     ISSN:  1524-4725     ISO Abbreviation:  Dermatol Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-05-10     Revised Date:  2010-12-17    
Medline Journal Info:
Nlm Unique ID:  9504371     Medline TA:  Dermatol Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  439-45     Citation Subset:  IM    
Affiliation:
Dermatology, Venereology, and Allergology, University School of Medicine Essen-Duisburg, Hufelandstr. 55, 45122 Essen, Germany. joachim.klode@uk-essen.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Fluorodeoxyglucose F18
Humans
Lymph Node Excision
Lymph Nodes / pathology*,  radiography,  radionuclide imaging*,  surgery
Lymphatic Metastasis
Male
Melanoma / diagnosis*,  pathology,  secondary*,  surgery
Middle Aged
Neoplasm Staging
Positron-Emission Tomography
Retrospective Studies
Sentinel Lymph Node Biopsy / methods*
Skin Neoplasms / diagnosis*,  pathology*,  surgery
Surgery, Computer-Assisted / methods*
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18
Comments/Corrections
Comment In:
Dermatol Surg. 2010 Dec;36(12):2082-3   [PMID:  21126282 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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