Is (18)FDG PET-CT useful for detecting occult nodal metastases in patients with cutaneous head and neck melanoma, in addition to sentinel lymph node biopsy?.
Fiche publication
Date publication
septembre 2010
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DOLIVET Gilles, Pr KARCHER Gilles, Pr OLIVIER Pierre
Tous les auteurs :
Revel A, Revel C, Dolivet G, Gillet N, Didot N, Meneroux B, Marie PY, Karcher G, Olivier P
Lien Pubmed
Résumé
Background and objectives. - In N0 cutaneous head and neck melanoma, sentinel lymph node biopsy (SLNB) is less reliable and accurate than in trunk or extremities melanoma (false negative cases and spotting failure). The aim of our study was to assess the utility of PET-CT (18)FDG in a specific group of NO patients, combined with SLNB. Patients and methods. - Twenty-two patients with N0 cutaneous head and neck melanoma were retrospectively reviewed. All of them had underwent PET-CT and SLNB before surgery. Average follow-up time was 17 months (1-44). Results. - At least one sentinel lymph node (SLN) was identified in 20 patients. Ten patients (50%) had metastatic SLN. Among these 10 N+ patients, PET-CT was positive for occult nodal metastases for only two patients. During follow-up, two patients had cervical nodal recurrence, whereas SLNB was negative. PET-CT was also negative for these two patients. SLNB and PET-CT sensitivity were respectively 83 and 18%. PET-CT specificity was 84% (regarding neck sides). Conclusion. - In this specific population with NO cutaneous head and neck melanoma, PET-CT sensitivity is too low and failed to detect occult nodal metastases in two patients with false negative SLNB. Consequently, PET-CT seems to be not useful for nodal staging NO cutaneous head and neck melanomas, in which SLNB is the most accurate technique. (C) 2010 Elsevier Masson SAS. All rights reserved.
Référence
Med Nucl-imag Fonct Metab. 2010 Sep;34(9):528-39.