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Effect of delay between nuclear medicine scanning and sentinel node biopsy on outcome in patients with cutaneous melanoma

Moncrieff, M. D. ; O'Leary, F. M. ; Beadsmoore, C. J. ; Pawaroo, D. ; Heaton, M. J. ; Isaksson, K. LU and Olofsson Bagge, R. (2020) In British Journal of Surgery 107(6). p.669-676
Abstract

Background: Sentinel lymph node biopsy (SLNB) is an important staging tool for the management of melanoma. A multicentre study was done to validate previous findings that the timing of lymphoscintigraphy influences the accuracy of SLNB and patient outcomes, particularly survival. Methods: Data were reviewed on patients undergoing SLNB for melanoma at three centres in the UK and Sweden, examining the effect of timing of SLNB after nuclear medicine scanning. Kaplan–Meier survival analysis was used to assess overall (OS), disease-specific (DSS) and progression-free (PFS) survival, stratified by timing of lymphoscintigraphy. Independent risk factors for survival were identified by Cox multivariable regression analysis. Results: A total of... (More)

Background: Sentinel lymph node biopsy (SLNB) is an important staging tool for the management of melanoma. A multicentre study was done to validate previous findings that the timing of lymphoscintigraphy influences the accuracy of SLNB and patient outcomes, particularly survival. Methods: Data were reviewed on patients undergoing SLNB for melanoma at three centres in the UK and Sweden, examining the effect of timing of SLNB after nuclear medicine scanning. Kaplan–Meier survival analysis was used to assess overall (OS), disease-specific (DSS) and progression-free (PFS) survival, stratified by timing of lymphoscintigraphy. Independent risk factors for survival were identified by Cox multivariable regression analysis. Results: A total of 2270 patients were identified. Median follow-up was 56 months. Univariable analysis showed a 4·2 per cent absolute and 35·5 per cent relative benefit in DSS (hazard ratio 1·36, 95 per cent c.i. 1·05 to 1·74; P = 0·018) for 863 patients whose SLNB was performed up to 12 h after lymphoscintigraphy compared with 1407 patients who had surgery after more than 12 h. There were similar OS and PFS benefits (P = 0·036 and P = 0·022 respectively). Multivariable analysis identified timing of lymphoscintigraphy as an independent predictor of OS (P = 0·017) and DSS (P = 0·030). There was an excess of nodal recurrences as first site of recurrence in the group with delayed surgery (4·5 versus 2·5 per cent; P = 0·008). Conclusion: Delaying SLNB beyond 12 h after lymphoscintigraphy with 99Tc-labelled nanocolloid has a significant negative survival impact in patients with melanoma.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Surgery
volume
107
issue
6
pages
8 pages
publisher
Oxford University Press
external identifiers
  • scopus:85079868321
  • pmid:32077090
ISSN
0007-1323
DOI
10.1002/bjs.11460
language
English
LU publication?
yes
id
43ff29c7-8680-4225-a688-ce61f4384f92
date added to LUP
2020-03-19 06:45:09
date last changed
2024-05-29 09:53:23
@article{43ff29c7-8680-4225-a688-ce61f4384f92,
  abstract     = {{<p>Background: Sentinel lymph node biopsy (SLNB) is an important staging tool for the management of melanoma. A multicentre study was done to validate previous findings that the timing of lymphoscintigraphy influences the accuracy of SLNB and patient outcomes, particularly survival. Methods: Data were reviewed on patients undergoing SLNB for melanoma at three centres in the UK and Sweden, examining the effect of timing of SLNB after nuclear medicine scanning. Kaplan–Meier survival analysis was used to assess overall (OS), disease-specific (DSS) and progression-free (PFS) survival, stratified by timing of lymphoscintigraphy. Independent risk factors for survival were identified by Cox multivariable regression analysis. Results: A total of 2270 patients were identified. Median follow-up was 56 months. Univariable analysis showed a 4·2 per cent absolute and 35·5 per cent relative benefit in DSS (hazard ratio 1·36, 95 per cent c.i. 1·05 to 1·74; P = 0·018) for 863 patients whose SLNB was performed up to 12 h after lymphoscintigraphy compared with 1407 patients who had surgery after more than 12 h. There were similar OS and PFS benefits (P = 0·036 and P = 0·022 respectively). Multivariable analysis identified timing of lymphoscintigraphy as an independent predictor of OS (P = 0·017) and DSS (P = 0·030). There was an excess of nodal recurrences as first site of recurrence in the group with delayed surgery (4·5 versus 2·5 per cent; P = 0·008). Conclusion: Delaying SLNB beyond 12 h after lymphoscintigraphy with <sup>99</sup>Tc-labelled nanocolloid has a significant negative survival impact in patients with melanoma.</p>}},
  author       = {{Moncrieff, M. D. and O'Leary, F. M. and Beadsmoore, C. J. and Pawaroo, D. and Heaton, M. J. and Isaksson, K. and Olofsson Bagge, R.}},
  issn         = {{0007-1323}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{669--676}},
  publisher    = {{Oxford University Press}},
  series       = {{British Journal of Surgery}},
  title        = {{Effect of delay between nuclear medicine scanning and sentinel node biopsy on outcome in patients with cutaneous melanoma}},
  url          = {{http://dx.doi.org/10.1002/bjs.11460}},
  doi          = {{10.1002/bjs.11460}},
  volume       = {{107}},
  year         = {{2020}},
}