title: Is there an indication for routine chest X-ray in initial staging of melanoma?
abstract: BACKGROUND
  Our aim was to evaluate therapeutic consequences of preoperative staging with Chest X-ray (CXR) in patients with a primary melanoma planned for sentinel node biopsy (SNB).
  
  
  METHODS
  From a prospective database, 248 medical records of patients treated for primary melanoma were extracted. CXRs were made prior to SNB, and examined by radiologists. Results were classified as follows: no metastasis, inconclusive, or suspect for metastasis. Furthermore, changes in planned treatment were recorded.
  
  
  RESULTS
  CXR was performed in 227 (92%) cases. In 95% of these patients, the CXR showed no metastasis. In 5%, the CXR was inconclusive; all of these CXR results appeared to be false-positive after complementary radiodiagnostic imaging and/or follow-up. All patients received a SNB.
  
  
  CONCLUSIONS
  Preoperative CXR did not identify pulmonary metastasis and did not change planned treatment strategies. We suggest that CXR has no added value in the routine workup of patients with a primary melanoma.
authors.affiliation: Department of Surgery, Maaslandhospital Sittard, Dr. H.van der Hoffplein 1, 6162 BG Sittard-Geleen, The Netherlands. l.vermeeren@nki.nl
authors.forename: Lenka
authors.initials: L
authors.lastname: Vermeeren
authors.forename: Fred W
authors.initials: FW
authors.lastname: van der Ent
authors.forename: Karel W
authors.initials: KW
authors.lastname: Hulsewé
mesh_terms: D016208:Databases, Factual; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011859:Radiography; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery