Preoperative imaging for early-stage cutaneous melanoma

Predictors, usage, and utility at a single institution

Dana Haddad, Erin M. Garvey, Laurie Mihalik, Barbara A Pockaj, Richard J. Gray, Nabil Wasif

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background Preoperative imaging for early-stage cutaneous melanoma is not recommended by current guidelines. Our goal was to investigate our institutional usage and utility. Methods Patients with clinically node-negative cutaneous melanoma undergoing surgery with sentinel lymph node biopsy were identified retrospectively. Any melanoma-related imaging after diagnosis and before surgery was considered a staging study. Results Five hundred fifteen studies were performed in 409 of 546 (75%) patients. Chest x-rays was performed in 70% and advanced imaging in 14% (computed tomography imaging, magnetic resonance imaging, ultrasound, and positron-emission computed tomography imaging). No metastatic lesions were identified. A Breslow thickness greater than 4 mm (odds ratio = 6.46 vs <1 mm; 95% confidence interval, 2.07 to 20.15) and male sex (odds ratio = 2.62 vs female; 95% confidence interval, 1.26 to 5.46) were associated with an increased likelihood of advanced imaging. Conclusions Preoperative imaging was performed in the majority of patients with node-negative melanoma, with 14% undergoing advanced studies. No metastatic lesions were identified, confirming the limited utility in this setting.

Original languageEnglish (US)
Pages (from-to)979-986
Number of pages8
JournalAmerican Journal of Surgery
Volume206
Issue number6
DOIs
StatePublished - Dec 2013

Fingerprint

Melanoma
Skin
Odds Ratio
Emission-Computed Tomography
Confidence Intervals
Sentinel Lymph Node Biopsy
Sex Ratio
Positron-Emission Tomography
Thorax
Tomography
Magnetic Resonance Imaging
X-Rays
Guidelines

Keywords

  • Melanoma
  • Preoperative imaging
  • Staging

ASJC Scopus subject areas

  • Surgery

Cite this

Preoperative imaging for early-stage cutaneous melanoma : Predictors, usage, and utility at a single institution. / Haddad, Dana; Garvey, Erin M.; Mihalik, Laurie; Pockaj, Barbara A; Gray, Richard J.; Wasif, Nabil.

In: American Journal of Surgery, Vol. 206, No. 6, 12.2013, p. 979-986.

Research output: Contribution to journalArticle

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abstract = "Background Preoperative imaging for early-stage cutaneous melanoma is not recommended by current guidelines. Our goal was to investigate our institutional usage and utility. Methods Patients with clinically node-negative cutaneous melanoma undergoing surgery with sentinel lymph node biopsy were identified retrospectively. Any melanoma-related imaging after diagnosis and before surgery was considered a staging study. Results Five hundred fifteen studies were performed in 409 of 546 (75{\%}) patients. Chest x-rays was performed in 70{\%} and advanced imaging in 14{\%} (computed tomography imaging, magnetic resonance imaging, ultrasound, and positron-emission computed tomography imaging). No metastatic lesions were identified. A Breslow thickness greater than 4 mm (odds ratio = 6.46 vs <1 mm; 95{\%} confidence interval, 2.07 to 20.15) and male sex (odds ratio = 2.62 vs female; 95{\%} confidence interval, 1.26 to 5.46) were associated with an increased likelihood of advanced imaging. Conclusions Preoperative imaging was performed in the majority of patients with node-negative melanoma, with 14{\%} undergoing advanced studies. No metastatic lesions were identified, confirming the limited utility in this setting.",
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