Use of preoperative PET/CT staging in sentinel lymph node–positive melanoma
Menée à partir de données portant sur 78 patients atteints d'un mélanome cutané avec envahissement du ganglion sentinelle, cette étude évalue l'intérêt d'utiliser, avant l'intervention chirurgicale, une tomographie numérique par émission de positrons pour stadifier la maladie
This retrospective review finds that positron emission tomography coupled with computed tomography has a high false-positive rate for sentinel lymph node mapping.
Sentinel lymph node (SLN) mapping is an integral part of the staging of cutaneous malignant melanoma. If regional metastases are identified on SLN biopsy, patients undergo completion lymph node dissection (LND) with curative intent. Microscopic regional lymph node involvement, however, is a strong predictor of disease-specific survival and delineates a population at high risk of developing metastatic melanoma.The National Comprehensive Cancer Network (NCCN) makes a category 2B recommendation based on low-level evidence for staging by positron emission tomography coupled with computed tomography (PET/CT) prior to LND. Discovery of occult synchronous metastases informs prognosis, may preclude LND, and presents an opportunity for metastasectomy, which can improve survival in patients with low-volume stage IV disease.
JAMA Oncology , résumé, 2014