Benefits of initial CT staging before sentinel lymph node biopsy in patients with head and neck cutaneous melanoma

Background The value of CT at the time of diagnosis for patients with cutaneous head and neck melanoma clinically asymptomatic for metastatic disease is unclear. Methods A retrospective medical chart review was performed on 198 consecutive patients identified with primary T1b‐T4b head and neck melan...

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Bibliographic Details
Published in:Head & neck 2017-11, Vol.39 (11), p.2301-2310
Main Authors: Hafström, Anna, Silfverschiöld, Maria, Persson, Simon S., Kanne, Michelle, Ingvar, Christian, Wahlberg, Peter, Romell, Anton, Greiff, Lennart
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biopsy
Computed tomography
diagnostic imaging
False Negative Reactions
False Positive Reactions
Female
Head and neck
head and neck neoplasms
Head and Neck Neoplasms - diagnostic imaging
Head and Neck Neoplasms - mortality
Head and Neck Neoplasms - pathology
Humans
Lymph
Lymph nodes
Lymphatic system
Male
Melanoma
Melanoma - diagnostic imaging
Melanoma - mortality
Melanoma - pathology
Melanoma, Cutaneous Malignant
Metastases
Metastasis
Middle Aged
Neoplasm Staging
Predictive Value of Tests
Retrospective Studies
Sentinel Lymph Node Biopsy
Skin Neoplasms - diagnostic imaging
Skin Neoplasms - mortality
Skin Neoplasms - pathology
staging
Survival Rate
Tomography, X-Ray Computed
Tumors
Young Adult
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Summary:Background The value of CT at the time of diagnosis for patients with cutaneous head and neck melanoma clinically asymptomatic for metastatic disease is unclear. Methods A retrospective medical chart review was performed on 198 consecutive patients identified with primary T1b‐T4b head and neck melanoma clinically asymptomatic for metastatic disease referred for sentinel lymph node biopsy procedures between 2004 and 2014. Results Initial CTs identified clinically occult melanoma metastases in 8.1% and advanced second primary tumors in 3.5% of patients. CT findings were false‐negative in 1% and false‐positive in 6% of patients. Overall survival (OS) for patients with true‐positive CT findings was lower than for the other patients (P < .001). Conclusion CT imaging when staging patients with head and neck melanoma seems to identify more metastases than has been reported for melanoma at other sites. Preoperative CTs decreased the number of sentinel lymph node biopsy (SLNBs), thus avoiding the stress and cost of this surgical procedure in 12% of patients.
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.24901