AI Article Synopsis
- Sentinel lymph node biopsy (SLNB) is a common method for staging cutaneous melanoma, but it has drawbacks such as high costs and possible side effects.
- The study aimed to assess the effectiveness of high-resolution ultrasound and power Doppler sonography (PDS) in identifying sentinel lymph nodes (SLNs) before surgery in melanoma patients.
- Findings showed that while the ultrasound technique identified some positive SLNs, it could not replace SLNB, but it could help in earlier diagnosis for certain patients, potentially allowing them to skip the SLNB and go directly to more extensive surgery.
Article Abstract
Background: Sentinel lymph node biopsy (SLNB) is a widely accepted procedure to accurately stage patients with cutaneous melanoma. Disadvantages of the SLNB procedure are the overall costs and potential side effects of the operation [J Dtsch Dermatol Ges 2009;7:318-327; J Am Dermatol 2010;62:737-748].
Objective: The purpose of our study was to evaluate whether high-resolution ultrasound combined with power Doppler sonography (PDS) is an appropriate tool for preoperative identification and characterization of sentinel lymph nodes (SLNs) in patients with cutaneous melanoma.
Methods: In a prospective study eighty-one consecutive patients with cutaneous melanoma (33 females and 48 males) in whom dissection of SLNs was indicated underwent ultrasound examinations before and after the preoperative lymphoscintigraphy.
Results: A total of 170 SLNs (mean 2.1 per patient) were removed and examined by histopathology. High resolution ultrasound combined with PDS correctly identified 2 of 9 positive SLNs. The sensitivity, specificity, positive predictive value, and negative predictive values of ultrasound were 22.2% (95% confidence interval (CI) = 2.8-60.0), 100% (95% CI = 97.7-100.0), 100.0% (95% CI = 15.8-100.0), and 95.8% (95% CI = 91.6-98.3), respectively.
Conclusions: Although high-resolution ultrasound combined with PDS cannot substitute SLNB, this technique offers earlier diagnosis of lymph node involvement in a small subgroup of patients (with subcapsular location of metastases), and introduces the possibility to exclude those patients from SLN procedure and directly prepare them for complete lymph node dissection (CLND).
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| http://dx.doi.org/10.1159/000325462 | DOI Listing |
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