caa a22 4500 445338040 CHVBK 20180317142802.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1272-0 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1272-0 Clinical Value of Radiographic Staging in Patients Diagnosed With AJCC Stage III Melanoma [Elektronische Daten] [Prakash Pandalai, Francisco Dominguez, James Michaelson, Kenneth Tanabe] Background: Patients with American Joint Committee on Cancer (AJCC) stage III melanoma represent patients with high risk of systemic relapse. This study evaluates the clinical utility of standardized radiographic staging. Methods: Consecutive asymptomatic patients underwent standardized radiographic staging workup within 6weeks of diagnosis. True- and false-positive rates and number of additional examinations generated after a positive initial report were quantified. All suspicious findings were further studied by biopsy and/or by clinical or radiologic assessment. Results: Fifty-eight patients underwent complete radiographic staging. Nineteen (33%) had ulcerated primary tumors. Forty-two patients (73%) presented with clinically negative lymph nodes that were positive on sentinel lymph node biopsy. Lymph node involvement was classified as N1a in 54%, N2a in 19%, N2b in 3%, and N3 in 22% of patients. Among 204 staging examinations in 58 patients, 52 (25%) were initially reported as positive. Three percent of all examinations proved truly positive; 23% were falsely positive. Analyzed per patient, in 37 (64%) of 58 patients, at least one examination was initially reported as positive. However, only 3 patients (5%) had a true-positive and 34 (59%) had at least one false-positive report. The positive reports of the staging scans generated 45 additional examinations (0.78 per patient). Conclusions: Radiographic staging in asymptomatic patients with stage III melanoma detects a low number of patients with unsuspected systemic disease. The ratio of falsely to truly positive is approximately 11:1. Radiographic screening should only be considered in patients with high-risk prognostic features or symptoms, or in the context of clinical trials. Society of Surgical Oncology, 2010 Pandalai Prakash Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA aut Dominguez Francisco Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA aut Michaelson James Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA aut Tanabe Kenneth Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 506-513 1068-9265 18:2<506 2011 18 10434 https://doi.org/10.1245/s10434-010-1272-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1272-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pandalai Prakash Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Dominguez Francisco Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Michaelson James Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Tanabe Kenneth Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 506-513 1068-9265 18:2<506 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer