{Reference Type}: Journal Article
{Title}: Role of Concurrent Ultrasound Surveillance of Sentinel Node-Positive Node Fields in Melanoma Patients Having Routine Cross-Sectional Imaging.
{Author}: Gjorup CA;Woodford R;Li I;Carlino MS;Ch'ng S;Chung D;Hsiao E;Lo SN;London K;Long GV;Menzies AM;Nieweg OE;Pennington TE;Rtshiladze MA;Saw RPM;Scolyer RA;Shannon KF;Spillane AJ;Stretch JR;Thompson JF;Varey AHR;van Akkooi ACJ;
{Journal}: Ann Surg Oncol
{Volume}: 31
{Issue}: 3
{Year}: 2024 Mar 15
{Factor}: 4.339
{DOI}: 10.1245/s10434-023-14526-9
{Abstract}: <B>OBJECTIVE: </B>In sentinel node-positive (SN+ve) melanoma patients, active surveillance with regular ultrasound examination of the node field has become standard, rather than completion lymph node dissection (CLND). A proportion of these patients now receive adjuvant systemic therapy and have routine cross-sectional imaging (computed tomography [CT] or positron emission tomography [PET]/CT). The role of concurrent ultrasound (US) surveillance in these patients is unclear. The purpose of our study was to describe the modality of detection of nodal recurrence in SN+ve node fields.<BR><B>METHODS: </B>SN+ve melanoma patients who did not undergo CLND treated at a single institution from January 1, 2016 to December 31, 2020 were included.<BR><B>RESULTS: </B>A total of 225 SN+ve patients with a median follow-up of 23 months were included. Of these, 119 (53%) received adjuvant systemic therapy. Eighty (36%) developed a recurrence at any site; 24 (11%) recurred first in the SN+ve field, of which 12 (5%) were confirmed node field recurrence only at 2 months follow-up. The nodal recurrences were first detected by ultrasound in seven (3%), CT in seven (3%), and PET/CT in seven (3%) patients. All nodal recurrences evident on US were also evident on PET/CT and vice versa.<BR><B>CONCLUSIONS: </B>The high rate of recurrences outside the node field and the identification of all US-detected nodal recurrences on concurrent cross-sectional imaging modalities suggest that routine concurrent ultrasound surveillance of the node-positive field may be unnecessary for SN+ve melanoma patients having routine cross-sectional imaging.