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Benefits of initial CT staging before sentinel lymph node biopsy in patients with head and neck cutaneous melanoma

Hafström, Anna LU ; Silfverschiöld, Maria; Persson, Simon S; Kanne, Michelle; Ingvar, Christian LU ; Wahlberg, Peter LU ; Romell, Anton and Greiff, Lennart LU (2017) In Head and Neck 39(11). p.2301-2310
Abstract (Swedish)
BACKGROUND: The value of CT at the time of diagnosis for patients with cutaneous head and neck melanoma clinically asymptomatic for metastatic disease is unclear.
METHODS: A retrospective medical chart review was performed on 198 consecutive patients identified with primary T1b-T4b head and neck melanoma clinically asymptomatic for metastatic disease referred for sentinel lymph node biopsy procedures between 2004 and 2014.
RESULTS: Initial CTs identified clinically occult melanoma metastases in 8.1% and advanced second primary tumors in 3.5% of patients. CT findings were false-negative in 1% and false-positive in 6% of patients. Overall survival (OS) for patients with true-positive CT findings was lower than for the other patients... (More)
BACKGROUND: The value of CT at the time of diagnosis for patients with cutaneous head and neck melanoma clinically asymptomatic for metastatic disease is unclear.
METHODS: A retrospective medical chart review was performed on 198 consecutive patients identified with primary T1b-T4b head and neck melanoma clinically asymptomatic for metastatic disease referred for sentinel lymph node biopsy procedures between 2004 and 2014.
RESULTS: Initial CTs identified clinically occult melanoma metastases in 8.1% and advanced second primary tumors in 3.5% of patients. CT findings were false-negative in 1% and false-positive in 6% of patients. Overall survival (OS) for patients with true-positive CT findings was lower than for the other patients (P < .001).
CONCLUSION: CT imaging when staging patients with head and neck melanoma seems to identify more metastases than has been reported for melanoma at other sites. Preoperative CTs decreased the number of sentinel lymph node biopsy (SLNBs), thus avoiding the stress and cost of this surgical procedure in 12% of patients. (Less)
Abstract

BACKGROUND: The value of CT at the time of diagnosis for patients with cutaneous head and neck melanoma clinically asymptomatic for metastatic disease is unclear.

METHODS: A retrospective medical chart review was performed on 198 consecutive patients identified with primary T1b-T4b head and neck melanoma clinically asymptomatic for metastatic disease referred for sentinel lymph node biopsy procedures between 2004 and 2014.

RESULTS: Initial CTs identified clinically occult melanoma metastases in 8.1% and advanced second primary tumors in 3.5% of patients. CT findings were false-negative in 1% and false-positive in 6% of patients. Overall survival (OS) for patients with true-positive CT findings was lower than for the other... (More)

BACKGROUND: The value of CT at the time of diagnosis for patients with cutaneous head and neck melanoma clinically asymptomatic for metastatic disease is unclear.

METHODS: A retrospective medical chart review was performed on 198 consecutive patients identified with primary T1b-T4b head and neck melanoma clinically asymptomatic for metastatic disease referred for sentinel lymph node biopsy procedures between 2004 and 2014.

RESULTS: Initial CTs identified clinically occult melanoma metastases in 8.1% and advanced second primary tumors in 3.5% of patients. CT findings were false-negative in 1% and false-positive in 6% of patients. Overall survival (OS) for patients with true-positive CT findings was lower than for the other patients (P < .001).

CONCLUSION: CT imaging when staging patients with head and neck melanoma seems to identify more metastases than has been reported for melanoma at other sites. Preoperative CTs decreased the number of sentinel lymph node biopsy (SLNBs), thus avoiding the stress and cost of this surgical procedure in 12% of patients.

(Less)
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author
publishing date
type
Contribution to journal
publication status
published
subject
in
Head and Neck
volume
39
issue
11
pages
2301 - 2310
publisher
John Wiley & Sons
external identifiers
  • scopus:85031685093
ISSN
1043-3074
DOI
10.1002/hed.24901
language
English
LU publication?
no
id
b97ab2ef-bad7-47d4-bae1-b4e9503df9b2
date added to LUP
2017-09-17 11:45:23
date last changed
2018-01-07 12:18:48
@article{b97ab2ef-bad7-47d4-bae1-b4e9503df9b2,
  abstract     = {<p>BACKGROUND: The value of CT at the time of diagnosis for patients with cutaneous head and neck melanoma clinically asymptomatic for metastatic disease is unclear.</p><p>METHODS: A retrospective medical chart review was performed on 198 consecutive patients identified with primary T1b-T4b head and neck melanoma clinically asymptomatic for metastatic disease referred for sentinel lymph node biopsy procedures between 2004 and 2014.</p><p>RESULTS: Initial CTs identified clinically occult melanoma metastases in 8.1% and advanced second primary tumors in 3.5% of patients. CT findings were false-negative in 1% and false-positive in 6% of patients. Overall survival (OS) for patients with true-positive CT findings was lower than for the other patients (P &lt; .001).</p><p>CONCLUSION: CT imaging when staging patients with head and neck melanoma seems to identify more metastases than has been reported for melanoma at other sites. Preoperative CTs decreased the number of sentinel lymph node biopsy (SLNBs), thus avoiding the stress and cost of this surgical procedure in 12% of patients.</p>},
  author       = {Hafström, Anna and Silfverschiöld, Maria and Persson, Simon S and Kanne, Michelle and Ingvar, Christian and Wahlberg, Peter and Romell, Anton and Greiff, Lennart},
  issn         = {1043-3074},
  language     = {eng},
  month        = {08},
  number       = {11},
  pages        = {2301--2310},
  publisher    = {John Wiley & Sons},
  series       = {Head and Neck},
  title        = {Benefits of initial CT staging before sentinel lymph node biopsy in patients with head and neck cutaneous melanoma},
  url          = {http://dx.doi.org/10.1002/hed.24901},
  volume       = {39},
  year         = {2017},
}