title: Doppler ultrasound flowmetry predicts 15 year outcome in patients with skin melanoma.
abstract: This prospective cohort study was conducted to find the role of tumor neovascularization in skin melanoma measured by preoperative Doppler ultrasound flowmetry in determining the 15-year outcome.
  
  
  METHODS
  Department of Surgery, University of Wales College of Medicine, Cardiff, UK. Seventy-one primary melanomas in 67 patients were studied with a 10 MHz Doppler ultrasound flowmeter. The flow signals were recorded on an audiotape. The peak systolic frequency, mean systolic frequency, and minimum diastolic frequency were measured on a spectrum analyzer. The follow-up (median 144 months) information is complete till December 2005 on 63 patients. Blood flow signals were detected in 41 lesions; these were labeled Doppler flow positive. No flow was detected in 22 lesions, labeled Doppler flow negative. Among the Doppler flow positive group, 39% patients have died with metastatic melanoma, whereas none of the patients with a Doppler-negative lesion have died or developed any recurrence. Higher peak systolic frequency (above 2,500 MHz.) was associated with a hazard ratio for death due to melanoma of (HAZARD RATE = 5.99). Higher risk of death, locoregional, and systemic recurrences were associated with higher peak systolic frequency. Doppler flowmetry performed preoperatively is a noninvasive, quick, and simple method to assess tumor blood flow which may help in predicting long-term survival and planning neoadjuvant therapies aimed at inhibiting angiogenesis or targeting tumor vasculature.
authors.affiliation: Department of Surgery, School of Medicine, Cardiff University, Cardiff, United Kingdom CF14 4XN ; Department of Surgery, All India Institute of Medical Sciences, New Delhi, India 110029.
authors.forename: Anurag
authors.initials: A
authors.lastname: Srivastava
authors.forename: John P
authors.initials: JP
authors.lastname: Woodcock
authors.forename: Robert E
authors.initials: RE
authors.lastname: Mansel
authors.forename: David J T
authors.initials: DJ
authors.lastname: Webster
authors.forename: Peter
authors.initials: P
authors.lastname: Laidler
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Hughes
authors.forename: Alok
authors.initials: A
authors.lastname: Dwivedi
keywords: Cohort study; Doppler ultrasound flowmetry; Malignant melanoma; Neovascularization; Recurrence; Survival; Tumor blood flow
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