Effect of delay between nuclear medicine scanning and sentinel node biopsy on outcome in patients with cutaneous melanoma

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Moncrieff, M. D.University of East Anglia,Norfolk and Norwich University Hospital NHS Trust (author)

Effect of delay between nuclear medicine scanning and sentinel node biopsy on outcome in patients with cutaneous melanoma

Article/chapterEnglish2020

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2020-02-19
Oxford University Press (OUP),2020

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LIBRIS-ID:oai:gup.ub.gu.se/291564
https://gup.ub.gu.se/publication/291564URI
https://doi.org/10.1002/bjs.11460DOI
https://lup.lub.lu.se/record/43ff29c7-8680-4225-a688-ce61f4384f92URI

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Language:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Background Sentinel lymph node biopsy (SLNB) is an important staging tool for the management of melanoma. A multicentre study was done to validate previous findings that the timing of lymphoscintigraphy influences the accuracy of SLNB and patient outcomes, particularly survival. Methods Data were reviewed on patients undergoing SLNB for melanoma at three centres in the UK and Sweden, examining the effect of timing of SLNB after nuclear medicine scanning. Kaplan-Meier survival analysis was used to assess overall (OS), disease-specific (DSS) and progression-free (PFS) survival, stratified by timing of lymphoscintigraphy. Independent risk factors for survival were identified by Cox multivariable regression analysis. Results A total of 2270 patients were identified. Median follow-up was 56 months. Univariable analysis showed a 4 center dot 2 per cent absolute and 35 center dot 5 per cent relative benefit in DSS (hazard ratio 1 center dot 36, 95 per cent c.i. 1 center dot 05 to 1 center dot 74; P = 0 center dot 018) for 863 patients whose SLNB was performed up to 12 h after lymphoscintigraphy compared with 1407 patients who had surgery after more than 12 h. There were similar OS and PFS benefits (P = 0 center dot 036 and P = 0 center dot 022 respectively). Multivariable analysis identified timing of lymphoscintigraphy as an independent predictor of OS (P = 0 center dot 017) and DSS (P = 0 center dot 030). There was an excess of nodal recurrences as first site of recurrence in the group with delayed surgery (4 center dot 5 versus 2 center dot 5 per cent; P = 0 center dot 008). Conclusion Delaying SLNB beyond 12 h after lymphoscintigraphy with Tc-99-labelled nanocolloid has a significant negative survival impact in patients with melanoma.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
american joint committee
intraoperative gamma-probe
breast-cancer
lymph-nodes
mitotic rate
lymphoscintigraphy
identification
metastasis
validation
age
Surgery

Added entries (persons, corporate bodies, meetings, titles ...)

O'Leary, F. M.Norfolk and Norwich University Hospital NHS Trust (author)
Beadsmoore, C. J.Norfolk and Norwich University Hospital NHS Trust (author)
Pawaroo, D.Norfolk and Norwich University Hospital NHS Trust (author)
Heaton, M. J.Norfolk and Norwich University Hospital NHS Trust (author)
Isaksson, K.Lund University,Lunds universitet,Lunds Melanomstudiegrupp,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Lund Melanoma Study Group,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital(Swepub:lu)kir-kis (author)
Olofsson Bagge, Roger,1978University of Gothenburg,Gothenburg University,Göteborgs universitet,Wallenberg Centre for Molecular and Translational Medicine,Sahlgrenska University Hospital(Swepub:gu)xoloro (author)
University of East AngliaNorfolk and Norwich University Hospital NHS Trust (creator_code:org_t)

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In:British Journal of Surgery: Oxford University Press (OUP)0007-13231365-2168

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By the author/editor: Moncrieff, M. D.; O'Leary, F. M.; Beadsmoore, C. J ...; Pawaroo, D.; Heaton, M. J.; Isaksson, K.; show more...; Olofsson Bagge, ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

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