title: The role of ultrasound of sentinel nodes in the pre- and post-operative evaluation of stage I melanoma patients.
abstract: We have investigated the role of high-resolution ultrasound (US) in the analysis of sentinel node(s) in melanoma patients in pre-operative staging and follow-up. One hundred and six lymph node basins in 88 melanoma patients undergoing sentinel node biopsy (SNB) were examined: 25 (23.6%) were US positive for metastases and 81 (76.4%) were negative. Subsequent histological analysis of the 81 negative lymph nodes confirmed the absence of metastases in 80 cases (98.8%), whereas, in the 25 US-positive lymph nodes, metastases were found in 16 cases (64%). The follow-up of all patients submitted to SNB in our unit included a US investigation of operated and contralateral nodal basins every 4 months for the first 3 years and then every 6 months. Of a total of 300 patients, four (1.6%) were found to have locoregional nodal disease during follow-up. In three of these four patients, US was crucial in indicating the presence of nodal metastases, which would have gone undetected on physical examination. The result of this study (negative predictive value of 98.7%) introduces the possibility of selecting patients who may avoid an SNB procedure based on the results of pre-operative US examination.
authors.affiliation: Melanoma Unit, European Institute of Oncology, Skin Cancer Unit, Center for Cancer Prevention, Milan, Italy. alessandro.testori@ieo.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Testori
authors.forename: Gianluca
authors.initials: G
authors.lastname: Lazzaro
authors.forename: Federica
authors.initials: F
authors.lastname: Baldini
authors.forename: Giulio
authors.initials: G
authors.lastname: Tosti
authors.forename: Massimo
authors.initials: M
authors.lastname: Mosconi
authors.forename: Elena
authors.initials: E
authors.lastname: Lovati
authors.forename: Chiara
authors.initials: C
authors.lastname: Bossi
authors.forename: Stefania
authors.initials: S
authors.lastname: Sanvito
authors.forename: Ignazio
authors.initials: I
authors.lastname: Stanganelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mazzarol
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: De Salvo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trifirò
authors.forename: Roberto
authors.initials: R
authors.lastname: Biffi
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellomi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D035002:Lower Extremity; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014463:Ultrasonography; D034941:Upper Extremity