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SPECT/CT Associated With Improved Survival in Melanoma

SPECT/CT-aided sentinel lymph node excision improves detection of metastases, outcome

SPECT/CT Associated With Improved Survival in Melanoma

TUESDAY, Sept. 11 (HealthDay News) -- For patients with clinically lymph node-negative melanoma, the use of single-photon emission computed tomography/computed tomography (SPECT/CT) to aid sentinel lymph node excision (SLNE) is associated with increased detection of metastatic involvement and improved disease-free survival, compared with standard SLNE, according to a study published in the Sept. 12 issue of the Journal of the American Medical Association.

Ingo Stoffels, M.D., from the University of Essen-Duisburg in Germany, and colleagues compared metastatic node detection and disease-free survival using SPECT/CT-aided SLNE versus standard SLNE in a cohort of 403 patients with melanoma with clinically negative lymph nodes.

A total of 254 patients underwent the standard SLNE technique and 149 underwent SPECT/CT-aided SLNE. The researchers found that use of SPECT/CT allowed SLNE more frequently in the head and neck area (2.0 percent for standard versus 23.5 percent for SPECT/CT; P < 0.001). More sentinel lymph nodes per patient were detected in the SPECT/CT cohort than in the standard cohort (2.40 versus 1.87; P < 0.001), and the number of positive sentinel lymph nodes per patient was significantly higher (0.34 versus 0.21; P = 0.04). In the SPECT/CT cohort, the local relapse rate was significantly lower (6.8 versus 23.8 percent; P = 0.03) and four-year disease-free survival was significantly higher (93.9 versus 79.2 percent; P = 0.02), compared to the standard cohort.

"Among patients with clinically lymph node-negative melanoma, the use of SPECT/CT-aided SLNE compared with SLNE alone was associated with a higher frequency of metastatic involvement and a higher rate of disease-free survival," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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