Preoperative ultrasound (US) assessment of regional lymph nodes in patients with melanoma does not provide accurate staging, according to a recent study in Annals of Surgery.
In a large multicenter trial, researchers aimed to determine whether preoperative US assessment of regional lymph nodes in patients with melanoma provides reliable nodal staging. Preoperative US data and sentinel node (SN) biopsy results for patients participating in the screening phase of the second Multicenter Selective Lymphadenectomy Trial (MLST-II) were analyzed.
Of the patients who had preoperative US evaluation, 3% had a positive US. Of the SN-positive patients, 7.1% had an abnormal US. According to lymph node basin analysis, 1.2% were true positive and the sensitivity of US was 6.6% (95% CI, 4.6-8.7) and the specificity 98.0% (95% CI, 97.5-98.5).
“In the MSLT-II screening phase population, SN tumor volume was usually too small to be reliably detected by US,” concluded the study authors. “For accurate nodal staging to guide the management of [patients with] melanoma, US is not an effective substitute for SN biopsy,” they continued. –Lisa Kuhns
Reference
Thompson JF, Haydu LE, Uren RF, et al. Preoperative ultrasound assessment of regional lymph nodes in melanoma patients does not provide reliable nodal staging: results from a large multicenter trial. Ann Surg. 2021;273(4):814-820. doi:10.1097/SLA.0000000000003405
