Navigation Links
Technique using CT linked with improved detection of lymph node metastasis in patients with melanoma
Date:9/11/2012

Preoperative 3-dimensional visualization of sentinel lymph nodes (SLNs) with a technique known as single-photon emission computed tomography/computed tomography was associated with a higher rate of detection of positive SLNs and a higher rate of disease-free survival among patients with melanoma, according to a study in the September 12 issue of JAMA.

"Melanoma has become an increasing interdisciplinary public health challenge worldwide. According to the World Health Organization, the incidence of melanoma is increasing faster than any other cancer in the world. Melanoma is the third most common cancer in Australia and the fifth most common cancer in the United States. The American Cancer Society estimated that approximately 70,230 new melanomas were diagnosed in the United States during 2011, resulting in approximately 8,790 deaths," according to background information in the article. "Because melanoma, depending on tumor depth, metastasizes early into regional lymph nodes, sentinel lymph node excision (SLNE) is probably the most important diagnostic and potentially therapeutic procedure for patients with melanoma. The histological status of the sentinel lymph node is the most relevant prognostic factor for overall survival in patients with melanoma, independent of primary tumor thickness." The authors add that the recently introduced hybrid single-photon emission computed tomography/computed tomography (SPECT/CT) imaging technique could help overcome the high false-negative rate of SLNE by providing additional anatomical information to the surgeon.

Ingo Stoffels, M.D., of the University of Essen-Duisburg, Essen, Germany, and colleagues conducted a study to compare the association between SLNE with vs. without preoperative SPECT/CT imaging and metastatic node detection and disease-free survival in patients with cutaneous melanoma. The study included use of a melanoma patient database to identify a group of 464 patients eligible for SLNE between March 2003 and April 2011. A total of 403 patients with clinically negative lymph nodes, who underwent SLNE with or without preoperative SPECT/CT, qualified for subsequent analysis. Between March 2003 and October 2008, 254 patients with melanoma underwent SLNE without preoperative SPECT/CT. Between November 2008 and April 2011, all sentinel node scintigraphies (type of diagnostic imaging tests) were performed as SPECT/CT in 149 patients. Using SPECT/CT allowed SLNE in the head and neck area more frequently (2.0 percent for standard vs. 23.5 percent for SPECT/CT).

A total of 833 SLNs were removed from 403 patients. The researchers found 2.40 SLNs per patient in the SPECT/CT group and 1.87 SLNs per patient in the standard group; 51 of 358 excised SLNs (14.2 percent) in the SPECT/CT cohort and 54 of 475 SLNs (11.4 percent) in the standard cohort showed metastatic involvement. The authors were able to identify 41 patients (27.5 percent) with positive SLNs in the SPECT/CT cohort and 48 (18.9 percent) with positive SLNs in the standard cohort. The number of positive SLNs per patient was significantly higher in the SPECT/CT cohort than in the standard cohort (0.34 vs. 0.21).

"The local relapse rate in the SPECT/CT cohort was lower than in the standard cohort (6.8 percent vs. 23.8 percent), which prolonged 4-year disease-free survival (93.9 percent vs. 79.2 percent)," the researchers write.

The authors note that with the SPECT/CT technique, they were able to use smaller incisions in the head and neck area as well as alternative entry points due to the exact anatomical localization of the SLN.

"In conclusion, the preoperative visualization of SLN with SPECT/CT is technically feasible and facilitates the detection of additional positive SLNs. The use of this technique offers the physician the preoperative possibility of determining the exact location and visualization of the SLN", the researchers write. "In patients with cutaneous melanoma, the use of SPECT/CT-aided SLNE compared with SLNE alone was associated with higher detection of metastatic involvement and a higher rate of disease-free survival."


'/>"/>

Contact: Joachim Klode, M.D.
joachim.klode@uk-essen.de
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. New MRI technique may predict progress of dementias
2. Detecting malaria early to save lives: New optical technique promises rapid and accurate diagnosis
3. New technique may help severely damaged nerves regrow and restore function
4. New Techniques May Improve Infant Heart Surgery
5. New surgical technique for removing inoperable tumors of the abdomen
6. New technique predictably generates complex, wavy shapes
7. Screening for breast cancer without X-rays: Lasers and sound merge in promising diagnostic technique
8. A marker in the lining of the lungs could be useful diagnostic technique for lung cancer screening
9. New technique could reduce number of animals needed to test chemical safety
10. Technique spots disease using immune cell DNA
11. Noninvasive imaging technique may help kids with heart transplants
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/11/2016)... ... February 11, 2016 , ... According to an article ... as a weight loss dietary supplement, is being recalled due to the discovery that ... because there is not a single supplement on the market proven to help people ...
(Date:2/11/2016)... ... February 11, 2016 , ... Dr. Sadati’s recent feature ... procedures. Along with performing procedures, the magazine also highlights that Dr. Sadati has ... One of the most common procedures he performs is his natural facelift. “As ...
(Date:2/11/2016)... (PRWEB) , ... February 11, 2016 , ... The president ... DoD Military Health System but would shift more of the cost burden to military ... TRICARE-reform plan laid out in the defense budget as including limited quantifiable benefit fixes ...
(Date:2/11/2016)... (PRWEB) , ... February 11, 2016 , ... ... surgery, dermatology and women’s health, is pleased to announce the promotions of Allison ... Partners sales team, Steve Catone to executive vice president of North American capital ...
(Date:2/11/2016)... Laurel, NJ (PRWEB) , ... February 11, 2016 ... ... announces the call for nominations seeking candidates for the Board of Commissioners. Individuals ... with passion, skills and experience with diversity of clinical practice settings and across ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... 2016 Potrero Medical, Inc., the developer of the ... appointment of George M. Rapier, III , MD, to ... , WellMed is one of the nation,s largest physician ... members in Texas and ... his own internal medicine practice, he has been instrumental to ...
(Date:2/11/2016)... AAIPharma Services Corp./Cambridge Major Laboratories, Inc. ... development services for the pharmaceutical and biotechnology industries, ... in its Charleston, SC ... recent investments. Charleston ... with small-scale lyophilization. The site has invested in ...
(Date:2/11/2016)... SEOUL, South Korea , Feb. 11, 2016 Wearable posture tracker, ALEX , has ... project fully funded and just seven days left to go, ALEX is said to be delivered to ... http://photos.prnewswire.com/prnh/20160211/332248 ... ... ...
Breaking Medicine Technology: