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

Anna Hafström; Maria Silfverschiöld; Simon S Persson; Michelle Kanne; Christian Ingvar; Peter Wahlberg; Anton Romell; Lennart Greiff

doi:10.1002/hed.24901

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

Anna Hafström, Maria Silfverschiöld, Simon S Persson, Michelle Kanne, Christian Ingvar, Peter Wahlberg, Anton Romell, Lennart Greiff

Skåne University Hospital

Research output: Contribution to journal › Article › peer-review

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 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.

Original language	English
Pages (from-to)	2301-2310
Journal	Head and Neck
Volume	39
Issue number	11
Early online date	2017 Aug 21
DOIs	https://doi.org/10.1002/hed.24901
Publication status	Published - 2017
Externally published	Yes

Subject classification (UKÄ)

Surgery

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10.1002/hed.24901

Riskfaktorer, prognos och överlevnad för patienter med maligna melanom i huvud- och halsområdet
Hafström, A., Jönsson, G. B., Ingvar, C., Isaksson, K. & Greiff, L.
2018/01/01 → 2023/12/31
Project: Research

Cite this

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

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 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.",

author = "Anna Hafstr{\"o}m and Maria Silfverschi{\"o}ld and Persson, {Simon S} and Michelle Kanne and Christian Ingvar and Peter Wahlberg and Anton Romell and Lennart Greiff",

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year = "2017",

doi = "10.1002/hed.24901",

language = "English",

volume = "39",

pages = "2301--2310",

journal = "Head and Neck",

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TY - JOUR

T1 - Benefits of initial CT staging before sentinel lymph node biopsy in patients with head and neck cutaneous melanoma

AU - Hafström, Anna

AU - Silfverschiöld, Maria

AU - Persson, Simon S

AU - Kanne, Michelle

AU - Ingvar, Christian

AU - Wahlberg, Peter

AU - Romell, Anton

AU - Greiff, Lennart

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

U2 - 10.1002/hed.24901

DO - 10.1002/hed.24901

M3 - Article

C2 - 28833785

SN - 1043-3074

VL - 39

SP - 2301

EP - 2310

JO - Head and Neck

JF - Head and Neck

IS - 11

ER -

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

Abstract

Subject classification (UKÄ)

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Riskfaktorer, prognos och överlevnad för patienter med maligna melanom i huvud- och halsområdet

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