Time to Procedure, Nuclear Imaging and Clinicopathological Characteristics as Predictive Factors for Sentinel Lymph Node Metastasis in Cutaneous Melanoma: A Single-Center Analysis
Objective Sentinel lymph node (SLN) biopsy is a widely accepted staging procedure for cutaneous melanoma patients who are at risk of clinically occult nodal metastases. Numerous predictive factors for regional lymph node metastases have been identified; however, few have been found to be reproducibly significant. Also, the role of blue dye in identification was questioned in recent trials. Time to procedure was also found to be predictive of SLN positivity, but this was not confirmed in other studies. In our study, predictive factors for metastatic involvement of SLN were analyzed, together with the role of addition blue dye in imaging on detection rate and false-negative SLN rate. An impact of time interval to procedure on the rate of SLN positivity was also explored. Methods Data analysis was done in 362 cutaneous melanoma patients who underwent lymphoscintigraphy and SLN biopsy at our institution from 2010 to 2016, with a median follow-up of 29 months (1–98 months). To delineate the relation of each variable (demographical, time to procedure, and clinical and pathological variables, as well as the presence of in-transit nodes, the number of draining basins, and SLN localization on scintigraphy) with positive SLN status, we used univariate logistic regression with odds ratios representing effect size. Results Metastatic involvement SLN was found in 67 (18.8%) of 356 patients. Detection rate was similar with or without further intraoperative SLN identification ...
For indentifying sentinel lymph nodes in melanoma, nonradioactive multispectral optoacoustic tomographic (MSOT) imaging does as well as conventional lymphoscintigraphic imaging, according to researchers in Germany.Reuters Health Information
ConclusionsLymphoscintigraphy with focused ultrasound follow-up of SNs is a reasonable management alternative to SNB in patients who are elderly and/or have substantial comorbidities.
No abstract available
1136Objectives: 1.To overview the current status of the identification of the sentinel lymph nodes (SLN), 2. To demonstrate the role of different scintigraphic techniques in SLN mapping, 3. To present the value of lymphoscintigraphy in malignancies, where its use is still limited. Abstract Body: Lymph node staging is essential for the prognosis and treatment in oncologic patients. SLN is the first draining lymph node on the direct lymphatic pathway from the primary tumor site and so it is the first node to harbour cancer cells detached from the primary tumor. SLN biopsy is a procedure in which the SLN is identified, remove...
Conclusions: Medium-energy collimator imaging is essential for SPECT imaging in sentinel node lymphoscintigraphy. The septal penetration artifacts seen with low energy collimation can result in non-visualization of the sentinel node and a high rate of false negative studies. Reference: 1. Bluemel C, Herrmann K, Giammarile F et al. EANM practice guidelines for lymphoscintigraphy and sentinel lymph node biopsy in melanoma. Eur J Nucl Med Mol Imaging. 2015 Oct;42(11):1750-1766.
CONCLUSIONS: Blue dye injection can be omitted without compromising the accuracy of standard SLNB. Omitting blue dye injection also has marked advantages in MMS for melanoma. This article is protected by copyright. All rights reserved. PMID: 31077333 [PubMed - as supplied by publisher]
We present four cases of [99mTc]Tilmanocept application after inconclusive or unsuccessful attempts of SLN detection using [99mTc]nanocolloid lymphoscintigraphy. PMID: 31064028 [PubMed - as supplied by publisher]
Publication date: Available online 19 March 2019Source: European Journal of Surgical OncologyAuthor(s): Fionnuala M. O'Leary, Clare J. Beadsmoore, Davina Pawaroo, John Skrypniuk, Martin J. Heaton, Marc D. Moncrieff
Publication date: Available online 10 March 2019Source: European Journal of Surgical OncologyAuthor(s): Torin H.A. Elmhirst, Amer J. Durrani, Animesh J.K. Patel
We present a multicenter, unblinded superiority randomized controlled trial to compare SPECT/CT-aided SLNE versus standard SLNE in melanoma patients.DiscussionThe primary efficacy endpoint is distant metastasis-free survival. Secondary endpoints comprise overall survival, disease-free survival, rate of local relapses within the follow-up period (false-negative rate of sentinel lymph node), number of positive sentinel lymph nodes (sensitivity, false-positive rate), complication rate, quality of life, quality-adjusted life years, inpatient days, and overall costs during hospital stays.Trial registrationClinicalTrials.gov,NCT...