Featured Research

from universities, journals, and other organizations

Technique using computed tomography associated with improved detection of lymph node metastasis in patients with melanoma

Date:
September 11, 2012
Source:
American Medical Association (AMA)
Summary:
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 new study.

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."


Story Source:

The above story is based on materials provided by American Medical Association (AMA). Note: Materials may be edited for content and length.


Journal Reference:

  1. Stoffels I, Boy C, P๖ppel T, et al. Association Between Sentinel Lymph Node Excision With or Without Preoperative SPECT/CT and Metastatic Node Detection and Disease-Free Survival in Melanoma. JAMA, 2012; 308 (10): 1007-1014 DOI: 10.1001/2012.jama.11030

Cite This Page:

American Medical Association (AMA). "Technique using computed tomography associated with improved detection of lymph node metastasis in patients with melanoma." ScienceDaily. ScienceDaily, 11 September 2012. <www.sciencedaily.com/releases/2012/09/120911161453.htm>.
American Medical Association (AMA). (2012, September 11). Technique using computed tomography associated with improved detection of lymph node metastasis in patients with melanoma. ScienceDaily. Retrieved July 25, 2014 from www.sciencedaily.com/releases/2012/09/120911161453.htm
American Medical Association (AMA). "Technique using computed tomography associated with improved detection of lymph node metastasis in patients with melanoma." ScienceDaily. www.sciencedaily.com/releases/2012/09/120911161453.htm (accessed July 25, 2014).

Share This




More Health & Medicine News

Friday, July 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

Beatings and Addiction: Pakistan Drug 'clinic' Tortures Patients

AFP (July 24, 2014) — A so-called drugs rehab 'clinic' is closed down in Pakistan after police find scores of ‘patients’ chained up alleging serial abuse. Duration 03:05 Video provided by AFP
Powered by NewsLook.com
Too Few Teens Receiving HPV Vaccination, CDC Says

Too Few Teens Receiving HPV Vaccination, CDC Says

Newsy (July 24, 2014) — The Centers for Disease Control and Prevention is blaming doctors for the low number of children being vaccinated for HPV. Video provided by Newsy
Powered by NewsLook.com
New Painkiller Designed To Discourage Abuse: Will It Work?

New Painkiller Designed To Discourage Abuse: Will It Work?

Newsy (July 24, 2014) — The FDA approved Targiniq ER on Wednesday, a painkiller designed to keep users from abusing it. Like any new medication, however, it has doubters. Video provided by Newsy
Powered by NewsLook.com
Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Doctor At Forefront Of Fighting Ebola Outbreak Gets Ebola

Newsy (July 24, 2014) — Sheik Umar Khan has treated many of the people infected in the Ebola outbreak, and now he's become one of them. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

    Health News

      Environment News

        Technology News



          Save/Print:
          Share:  

          Free Subscriptions


          Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

          Get Social & Mobile


          Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

          Have Feedback?


          Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
          Mobile iPhone Android Web
          Follow Facebook Twitter Google+
          Subscribe RSS Feeds Email Newsletters
          Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins