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01-07-2016 | Melanomas

The Diagnostic Value of PET/CT Imaging in Melanoma Groin Metastases

Authors: Julia van Wissen, MD, Bernies van der Hiel, MD, Jos A. van der Hage, MD, PhD, Bart A. van de Wiel, MD, Michel W. J. M. Wouters, MD, PhD, Alexander C. J. van Akkooi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2016

Abstract

Background

Combined superficial (inguinal) and deep (iliac and obturator) groin dissection (CGD) is the standard treatment of patients with stage IIIB and IIIC melanoma groin metastases; however, the additional value of iliac lymphadenectomy is debated. In our institute, imaging with positron emission tomography/computed tomography (PET/CT) is part of the regular preoperative work-up. The aim of this study was to evaluate the diagnostic value of PET/CT in detecting iliac lymph node metastases.

Patients and Methods

This retrospective study included 70 melanoma patients with stage IIIB or IIIC melanoma and an indication for therapeutic CGD, who were treated at our institution between 2003 and 2013. Median disease-free survival (DFS) was 9 months and median follow-up time was 16 months. The results of PET/CT were compared with the results of pathological analysis after CGD. Additional quantitative analysis of PET/CT imaging was performed.

Results

For superficial melanoma groin metastases, sensitivity of PET/CT was 97 %, specificity was 50 %, positive predictive value (PPV) was 90 %, and negative predictive value (NPV) was 71 %. For iliac lymph node metastases, sensitivity of PET/CT was 67 %, specificity was 91 %, PPV was 73 %, NPV was 81 %, and false negative rate was 33 %.

Conclusions

The results of this retrospective study indicate that PET/CT imaging could be a valuable method in preoperative work-up in this patient category; however, PET/CT alone should not be used as a tool to determine the extent of surgery, since one-third of patients with iliac lymph node involvement will be missed on PET/CT.

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Title: The Diagnostic Value of PET/CT Imaging in Melanoma Groin Metastases
Authors: Julia van Wissen, MD
Bernies van der Hiel, MD
Jos A. van der Hage, MD, PhD
Bart A. van de Wiel, MD
Michel W. J. M. Wouters, MD, PhD
Alexander C. J. van Akkooi, MD, PhD
Publication date: 01-07-2016
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 7/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-016-5142-2

At a glance: The STEP trials

Springer Medicine

The Diagnostic Value of PET/CT Imaging in Melanoma Groin Metastases

Abstract

Background

Patients and Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Patients and Methods

Results

Conclusions

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