1. 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.
- Author
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Klode J, Dissemond J, Grabbe S, Hillen U, Poeppel T, and Boeing C
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Fluorodeoxyglucose F18, Humans, Lymph Node Excision, Lymph Nodes surgery, Lymphatic Metastasis, Male, Melanoma pathology, Melanoma surgery, Middle Aged, Neoplasm Staging, Positron-Emission Tomography, Retrospective Studies, Skin Neoplasms surgery, Tomography, X-Ray Computed, Lymph Nodes diagnostic imaging, Lymph Nodes pathology, Melanoma diagnosis, Melanoma secondary, Sentinel Lymph Node Biopsy methods, Skin Neoplasms diagnosis, Skin Neoplasms pathology, Surgery, Computer-Assisted methods
- Abstract
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.
- Published
- 2010
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