Laboratory tests and imaging studies in patients with cutaneous malignant melanomas: a survey of experienced physicians.
BACKGROUND
The presence or absence of metastases is important in determining prognosis and treatment options for patients with malignant melanoma (MM). Laboratory tests and imaging studies are ordered for patients with MMs but without symptoms in an effort to detect occult metastases. However, which laboratory tests and imaging studies to order and how often to reorder them is not well established.


OBJECTIVE
Our purpose was to determine which tests and studies are ordered by physicians with major responsibilities for the care of patients with MM.


METHODS
Physicians were surveyed by questionnaire about the laboratory tests and imaging studies they ordered for MM stages 0, I, II, and III.


RESULTS
Of the 35 physicians queried, 30 (86%) responded to the survey. The majority of physicians order tests as follows: no tests for MM in situ; roentgenography of the chest with or without initial lactic acid dehydrogenase/liver function tests for stages I, II, and III and during follow-up for stages IB, II, and III (more frequently as the Breslow thickness increases); and baseline computed tomographic or magnetic resonance imaging scans of the chest, abdomen/pelvis, and brain for stage III.


CONCLUSIONS
Although the pattern of ordering examinations was similar for the majority of respondents, there was significant variability among experienced physicians in ordering laboratory tests and imaging studies in the search for occult metastases in patients with asymptomatic MM. The laboratory tests and imaging studies ordered and their frequency depend on the stage of the MM and sometimes on other risk factors.
Provost
N
N
Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, USA.
Marghoob
A A
AA
Kopf
A W
AW
DeDavid
M
M
Wasti
Q
Q
Bart
R S
RS
D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data*; D003880:Dermatology; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D008111:Liver Function Tests / Q000706:statistics & numerical data; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008495:Medical Oncology; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data
D007770:L-Lactate Dehydrogenase