Ultrasound-guided Fine Needle Aspiration Cytology prior to Sentinel Lymph Node Biopsy in Melanoma Patients |
| |
| Authors: | Christiane Voit MD Martina Kron PhD Gregor Schäfer MD Alfred Schoengen MD Heike Audring Ansgar Lukowsky Markus Schwürzer-Voit MD Wolfram Sterry MD Helmut Winter MD Jürgen Rademaker MD |
| |
| Affiliation: | (1) Department of Dermatology of the Charité, Humboldt University, Berlin, Germany;(2) Department of Biometry and Medical Documentation, University of Ulm, Ulm, Germany;(3) Department of Medical Oncology, Armed Forces Hospital, University of Ulm, Ulm, Germany;(4) Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA |
| |
| Abstract: | Background Sentinel lymph node biopsy (SLNB) allows early detection of metastases, thereby enabling early treatment in melanoma patients likely to benefit from adjuvant therapies. This prospective study analyzes the possible benefits of additional ultrasound (US) and fine needle aspiration cytology (FNAC) of sentinel nodes (SN) prior to SLNB.Method Over a 2-year period 127 melanoma patients with 151 SN were scheduled for SLNB. All SN were initially identified with lymphoscintigraphy, then identified and evaluated by US and the cells aspirated for cytology (FNAC). US findings and FNAC results were compared to surgical findings.Results Of 127 patients, 114 had one SN each, 12 had two, and one had three. In vivo US achieved a sensitivity of 79% (95% CI: 62–91%) and a specificity of 72% (95% CI: 62–81%). FNAC showed a sensitivity of 59% (95% CI: 41–76%) and a specificity of 100% (95% CI: 95–100%). The combination of these two in vivo methods achieved an overall sensitivity of 82% (95% CI: 65–93%) and an overall specificity of 72% [95% CI: 62–81%].Conclusion Combined US and FNAC provides important information prior to SLNB in that both procedures identify metastases in the lymph nodes (sensitivity > 80%). Patients with positive FNAC may proceed directly to complete lymph node dissection (cLND) instead of having initial SLNB. Thus, combined US and FNAC may prevent unnecessary anesthesia and surgical management as well reduce costs. In our study 16% (19/121) fewer SLNB procedures were carried out, subsequently replaced by cLND. For patients with a negative combination of in vivo US and FNAC, SLNB remains the best diagnostic option.Part of this work was presented in May 2003 at the Melanoma session of the 39th Annual Meeting of the American Society of Clinical Oncology in Chicago, Illinois, and at the Oral Melanoma Poster Discussion session of the 40th Annual Meeting of the American Society of Clinical Oncology in New Orleans, Louisiana. |
| |
| Keywords: | Sentinel lymph node biopsy Fine needle aspiration cytology Ultrasound Melanoma |
| 本文献已被 PubMed SpringerLink 等数据库收录！ |
|
