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01-08-2016 | Melanomas

SPECT/CT Improves Detection of Metastatic Sentinel Lymph Nodes in Patients with Head and Neck Melanoma

Authors: Brandon C. Chapman, MD, Ana Gleisner, MD, Jennifer J. Kwak, MD, Patrick Hosokawa, MS, Alessandro Paniccia, MD, Justin S. Merkow, MD, Phillip J. Koo, MD, Csaba Gajdos, MD, Nathan W. Pearlman, MD, Martin D. McCarter, MD, Nicole Kounalakis, MD

Published in: Annals of Surgical Oncology | Issue 8/2016

Abstract

Background

A positive sentinel lymph node (SLN) is the most important prognostic factor for predicting survival in cutaneous melanoma. This study aimed to evaluate how the addition of single-photon emission computed tomography (SPECT) and computed tomography (CT) to planar lymphoscintigraphy (PL) alters SLN identification, yield, and localization of metastatic nodes in head and neck melanoma.

Methods

This retrospective review examined patients undergoing SLN biopsy for cutaneous melanoma of the head and neck between July 2003 and December 2015. Patient demographics and pathologic outcomes were compared for patients undergoing SPECT-CT versus PL. A multivariable logistic regression analysis was used to identify factors associated with the identification of a positive SLN.

Results

Among 176 patients undergoing SLN biopsy, 91 underwent PL and 85 underwent SPECT-CT and PL. The patients in the SPECT-CT group were older than the PL patients (p = 0.050) but the groups did not differ in gender (p = 0.447), Breslow thickness (p = 0.744), or total number of SLNs identified (p = 0.633). As shown by the multivariate regression analysis, only Breslow thickness [odds ratio (OR) 1.47; 95 % confidence interval (CI) 1.17–1.84] and SPECT-CT (OR 3.58; 95 % CI 1.24–10.4) were associated with a positive SLN.

Conclusion

The use of SPECT-CT for patients with head and neck cutaneous melanoma significantly increases the likelihood of retrieving a positive SLN. Long-term follow-up evaluation is needed for further definition of the impact that SPECT-CT has on recurrence and survival.

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Title: SPECT/CT Improves Detection of Metastatic Sentinel Lymph Nodes in Patients with Head and Neck Melanoma
Authors: Brandon C. Chapman, MD
Ana Gleisner, MD
Jennifer J. Kwak, MD
Patrick Hosokawa, MS
Alessandro Paniccia, MD
Justin S. Merkow, MD
Phillip J. Koo, MD
Csaba Gajdos, MD
Nathan W. Pearlman, MD
Martin D. McCarter, MD
Nicole Kounalakis, MD
Publication date: 01-08-2016
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 8/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-016-5175-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

SPECT/CT Improves Detection of Metastatic Sentinel Lymph Nodes in Patients with Head and Neck Melanoma

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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