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Annals of Surgical Oncology

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01-07-2007 | Melanoma

Yield and Predictors of Radiologic Studies for Identifying Distant Metastases in Melanoma Patients with a Positive Sentinel Lymph Node Biopsy

Authors: Jason S. Gold, David P. Jaques, Klaus J. Busam, Mary S. Brady, Daniel G. Coit

Published in: Annals of Surgical Oncology | Issue 7/2007

Abstract

Background

It is common to obtain radiological studies around the time of a positive sentinel lymph node biopsy (SLNB) to exclude patients with distant metastases from completion lymph node dissection. The yield of such a work-up is unknown.

Methods

Patients were identified from a prospectively maintained database. Medical records were reviewed.

Results

Over an 8-year period, 181 patients had a positive SLNB. At least one study (computed tomography or magnetic resonance imaging of the brain; chest x-ray; computed tomography of the thorax, abdomen, or pelvis; positron-emission tomography scan; or bone scan) was obtained around the time of SLNB in 178 patients (98%). Studies were obtained after SLNB in 107 patients (59%). Studies ordered after SLNB resulted in indeterminate findings in 51 patients (48% of those studied). Among patients tested after SLNB, four were found to have metastatic disease (positive rate 3.7%). All of these patients had both a thick melanoma and macrometastasis within the SLN. The number of patients with indeterminate findings would be decreased and the yield of the work-up increased by 4 fold, by restricting the work-up to those with thick melanoma and macrometastasis.

Conclusions

Radiological studies obtained after a positive SLN produce indeterminate findings in about half of the patients and identify distant disease in 3.7%. Restricting work-up to patients with thick melanoma and macrometastasis on SLNB would spare patients from indeterminate findings and increase the yield of the evaluation.

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Title: Yield and Predictors of Radiologic Studies for Identifying Distant Metastases in Melanoma Patients with a Positive Sentinel Lymph Node Biopsy
Authors: Jason S. Gold
David P. Jaques
Klaus J. Busam
Mary S. Brady
Daniel G. Coit
Publication date: 01-07-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 7/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9399-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Yield and Predictors of Radiologic Studies for Identifying Distant Metastases in Melanoma Patients with a Positive Sentinel Lymph Node Biopsy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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