Visualization formats of patient-reported outcome measures in clinical practice: a systematic review about preferences and interpretation accuracy.

Purpose: The use of Patient-Reported Outcome Measures (PROMs) for individual patient management within clinical practice is becoming increasingly important. New evidence about graphic visualization formats for PROMs scores has become available. This systematic literature review evaluated evidence for graphic visualization formats of PROMs data in clinical practice for patients and clinicians, for both individual and group level PROMs data.

Predictive risk factors for sentinel lymph node nonvisualization on planar lymphoscintigraphy using an intratumoral injection in patients with primary breast cancer.

Objectives: Lymphoscintigraphy is considered a useful tool to optimize sentinel lymph node (SLN) identification. Nonvisualization of the SLN is associated with a lower SLN identification rate. The aim of this study was to identify preoperative factors associated with SLN nonvisualization on lymphoscintigraphy.

Sentinel lymph node nonvisualization after intratumoral radioisotope tracer injection in breast cancer is not associated with a higher nodal metastasis rate or worse outcomes.

Background And Objectives: Preoperative lymphoscintigraphy does not always visualize a sentinel lymph node (SLN). The study aim was to investigate whether persistent nonvisualization after additional single-photon emission computed tomography (SPECT)/CT or a second radiotracer injection in breast cancer patients is associated with nodal metastases or worse outcome due to potential understaging and consequently undertreatment.

Methods: Altogether 2042 consecutive SLN procedures were evaluated.

Blue dye can be safely omitted in most sentinel node procedures for melanoma.

Sentinel node biopsy is a widely used staging procedure in melanoma. It is usually performed using the triple technique: lymphatic mapping after injection of a radiopharmaceutical, blue dye injection, and the use of a gamma probe. Blue dye offers visual confirmation of the location of the sentinel lymph node (SN).

Five-year follow-up of 16 melanoma patients with a Starz I-involved sentinel node in whom completion lymph node dissection was omitted.

The aim of the study was to determine the incidence of lymph node recurrence in 16 melanoma patients with a minimal metastasis (Starz level I) in a sentinel node in whom a completion lymph node dissection was omitted. A secondary aim was to examine whether other melanoma-related recurrences developed. Sixteen melanoma patients with an SI-involved sentinel node, who did not undergo completion lymph node dissection, were followed for a median of 66 months.

Prognosis in patients with sentinel node-positive melanoma is accurately defined by the combined Rotterdam tumor load and Dewar topography criteria.

Purpose: Prognosis in patients with sentinel node (SN)-positive melanoma correlates with several characteristics of the metastases in the SN such as size and site. These factors reflect biologic behavior and may separate out patients who may or may not need additional locoregional and/or systemic therapy.

Patients And Methods: Between 1993 and 2008, 1,080 patients (509 women and 571 men) were diagnosed with tumor burden in the SN in nine European Organisation for Research and Treatment of Cancer (EORTC) melanoma group centers.

SPECT/CT for sentinel lymph node mapping in head and neck melanoma.

Background: The additional value of single photon emission computed tomography with CT (SPECT/CT) for detection and localization of sentinel nodes in patients with a melanoma of the head and neck was determined.

Methods: Thirty-eight patients received conventional lymphoscintigraphy followed by hybrid SPECT/CT. The number of sentinel nodes visualized and anatomic information provided were analyzed.

Lymphatic drainage patterns from the treated breast.

Introduction: Lymphatic drainage patterns from the breast have been described in the past. Drainage may change after treatment of a breast or axilla, and this may have implications for lymphatic mapping. The aim of this study was to determine the lymphatic drainage patterns in breast cancer patients with a previously treated ipsilateral breast.

SPECT/CT for preoperative sentinel node localization.

The value of SPECT/CT for detection and localization of sentinel nodes is reviewed. SPECT/CT depicts extra sentinel nodes and identifies non-nodal tracer accumulation. SPECT/CT is indicated in patients with complex lymphatic drainage as often present in patients with head, neck and scapular melanoma, breast cancer patients with extra-axillary sentinel nodes and patients with tumors draining to pelvic nodes.

Reevaluation of the locoregional recurrence rate in melanoma patients with a positive sentinel node compared to patients with palpable nodal involvement.

Background: The main aims of this study were to evaluate the occurrence of the various forms of locoregional recurrence in sentinel node-positive melanoma patients, to determine whether the different definitions that are being used to describe in-transit metastases influence this rate, and to identify factors associated with locoregional recurrence. A comparison was made with the rate of locoregional recurrence in patients who underwent lymph node dissection for palpable metastases.

Methods: Between December 1993 and December 2008, a total of 141 patients underwent completion lymph node dissection because of a tumor-positive sentinel node.

Evaluation of lymphatic drainage patterns to the groin and implications for the extent of groin dissection in melanoma patients.

Introduction: Early conventional lymphoscintigrams can distinguish sentinel nodes from second-tier nodes and the new SPECT/CT technology shows their precise anatomical location. The purpose of the study was to analyze lymphatic drainage patterns to the groin using these techniques and to determine the implications for a potential groin dissection.

Methods: Fifty-five groins in 50 patients were analyzed using lymphoscintigrams and SPECT/CT.

Comparison of three micromorphometric pathology classifications of melanoma metastases in the sentinel node.

Objective: The purposes of this study were to determine which classification best predicts additional lymph node disease and survival, and to suggest a threshold below which a completion dissection may be omitted.

Summary Background Data: Three micromorphometric parameters of melanoma sentinel node metastases were compared: invasion depth from the capsule (Starz-classification), maximum diameter (Rotterdam-criteria), and location within the node (Dewar-classification).

Methods: The pathology slides of 116 patients with tumor-positive sentinel nodes were reviewed.

Is completion lymph node dissection needed in case of minimal melanoma metastasis in the sentinel node?

Objective: The purpose of this study was to evaluate the micromorphometric Starz-classification in melanoma patients.

Summary Background Data: The micromorphometric Starz-classification suggests that melanoma patients with a sentinel node metastasis invading no more than 0.3 mm (S-I) or 0.

Lymphatic drainage patterns in breast cancer patients who previously underwent mantle field radiation.

Background: Lymphatic drainage may change after radiation of a breast or its regional lymph node basins, and this may have implications for lymphatic mapping afterward. The aim of this study was to determine the lymphatic drainage patterns in breast cancer patients who had undergone mantle field radiation for Hodgkin's lymphoma in the past.

Methods: Between January 1999 and November 2008, 22 breast cancer patients underwent a sentinel node procedure after previous mantle field radiation.

Visualization of tumor blockage and rerouting of lymphatic drainage in penile cancer patients by use of SPECT/CT.

Unlabelled: The reliability of sentinel node biopsy is dependent on the accurate visualization and identification of the sentinel node(s). It has been suggested that extensive metastatic involvement of a sentinel node can lead to blocked inflow and rerouting of lymph fluid to a "neo-sentinel node" that may not yet contain tumor cells, causing a false-negative result. However, there is little evidence to support this hypothesis.

The yield of SPECT/CT for anatomical lymphatic mapping in patients with melanoma.

Background: The hybrid single-photon emission computed tomography camera with integrated CT (SPECT/CT) fuses tomographic lymphoscintigrams with anatomical CT data. SPECT/CT shows the exact anatomical location of a sentinel node and may detect additional drainage. The purpose of this study was to explore its potential in patients with melanoma.

The yield of SPECT/CT for anatomical lymphatic mapping in patients with breast cancer.

Purpose: The recently introduced hybrid single-photon emission computed tomography camera with integrated CT (SPECT/CT) fuses tomographic lymphoscintigrams with anatomical data from CT. The purpose of this study was to explore this sophisticated technique in lymphatic mapping in breast cancer patients.

Methods: We studied 134 patients who underwent SPECT/CT immediately after late planar imaging when these images showed an unusual drainage pattern (85 patients), a pattern that was difficult to interpret (27 patients), or nonvisualization (22 patients).

Breast cancer patients with extra-axillary sentinel nodes only may be spared axillary lymph node dissection.

Background: In breast cancer patients with only extra-axillary sentinel nodes, surgeons typically perform axillary node dissection. The purpose of this study was to evaluate our approach to spare such patients further dissection based on the hypothesis that a sentinel node is not necessarily located in the axilla.

Methods: Between March 11, 1999 and March 5, 2008, 1,949 breast cancer patients underwent lymphatic mapping with preoperative lymphoscintigraphy and intraoperative use of a gamma-ray detection probe and patent blue dye.

The hidden sentinel node and SPECT/CT in breast cancer patients.

Purpose: In a minority of breast cancer patients, lymphoscintigraphy shows no lymphatic drainage and 'hidden' sentinel nodes may remain undiscovered. The purpose of this study was to explore the additional value of the recently introduced hybrid SPECT/CT in breast cancer patients with axillary non-visualisation on planar images. The role of blue dye and careful palpation of the axilla was evaluated in patients in whom axillary sentinel nodes remained hidden after SPECT/CT.

The efficacy of 'radio guided occult lesion localization' (ROLL) versus 'wire-guided localization' (WGL) in breast conserving surgery for non-palpable breast cancer: a randomized clinical trial - ROLL study.

Background: With the increasing number of non palpable breast carcinomas, the need of a good and reliable localization method increases. Currently the wire guided localization (WGL) is the standard of care in most countries. Radio guided occult lesion localization (ROLL) is a new technique that may improve the oncological outcome, cost effectiveness, patient comfort and cosmetic outcome.

The Hybrid SPECT/CT as an additional lymphatic mapping tool in patients with breast cancer.

Background: Conventional lymphoscintigraphy does not always define the exact anatomic location of a sentinel node. The lymphatic drainage pattern may be unusual or may not be shown at all. The recently introduced hybrid SPECT/CT imaging could help overcome these difficulties.

Tumor-positive sentinel node biopsy of the groin in clinically node-negative melanoma patients: superficial or superficial and deep lymph node dissection?

Background: The extent of a completion groin dissection in sentinel node-positive melanoma patients was guided by the location of the second-echelon nodes on the preoperative lymphoscintigram. The purposes of the current study were to investigate the pathological findings, the lymph node recurrences and (disease-free) survival associated with this approach.

Methods: Between June 1996 and April 2007, 42 patients underwent completion groin dissection after a tumor-positive sentinel node biopsy.

Axillary and extra-axillary lymph node recurrences after a tumor-negative sentinel node biopsy for breast cancer using intralesional tracer administration.

Background: At our institution, tracer fluids are administered in the primary breast cancer and, in addition to the ones in the axilla, sentinel nodes outside the axilla are rigorously pursued. The objective of the present study of sentinel node-negative breast cancer patients was to determine the lymph node recurrence rates in the axilla and elsewhere, the false-negative rates, and the survival.

Methods: Between January 1999 and November 2005, 1,019 breast cancer patients underwent a sentinel node biopsy.

The additional value of SPECT/CT in lymphatic mapping in breast cancer and melanoma.

Unlabelled: The recently introduced SPECT/CT integrates the physiologic data of SPECT with the anatomic data of CT into a single image. The purpose of this pilot study was to explore the additional value of SPECT/CT in breast cancer patients and melanoma patients with inconclusive planar image findings.

Methods: Thirty-one patients had planar lymphoscintigrams showing unexpected lymphatic drainage, 6 had lymphoscintigrams that were difficult to interpret, and 3 showed no drainage on planar imaging.