Diagnostic accuracy of imaging studies for initial staging of T2b to T4b melanoma patients: A cross-sectional study

Loughlin, Constanza Riquelme‐Mc; Podlipnik, Sebastián; Bosch‐Amate, Xavier; Riera‐Monroig, Josep; Barreiro, Álvaro; Espinosa, Natalia; Moreno‐Ramírez, D.; Giavedoni, Priscila; Vilana, R.; Sánchez, Marcelo; Vidal-Sicart, Sergi; Carrera, Cristina; Malvehy, Josep; Puig, Susana

doi:10.1016/j.jaad.2019.05.076

Cited by 12 publications

(5 citation statements)

References 32 publications

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“…In patients with stage T4b, CT, or PET, CT is suitable for the detection of metastasis. Brain MRI at T4b deserves further discussion, considering the ultimate clinical benefit in terms of management and therapeutic options for asymptomatic patients [132].…”

Section: General Principlesmentioning

confidence: 99%

European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics – Update 2019

Garbe¹,

Amaral

Peris

et al. 2020

European Journal of Cancer

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158

161

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Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. The diagnosis of melanoma can be made clinically and shall always be confirmed through dermatoscopy. If a melanoma is suspected, a histopathological examination is required. Sequential digital dermatoscopy and fullbody photography can be used in risk persons to detect the development of melanomas at an earlier stage. Where available, confocal reflectance microscopy can improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the AJCC classification. Thin melanomas up to 0.8 mm tumor thickness does not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC whole-body examinations with CT or PET-CT in combination with brain MRI are recommended. From stage III and higher, mutation testing is recommended, particularly for BRAF V600 mutation. It is important to provide a structured follow-up to detect relapses and secondary primary melanomas as early as possible. There is no evidence to support the frequency and extent of examinations. A stagebased follow-up scheme is proposed, which, according to the experience of the guideline group, covers the minimum requirements; further studies may be considered. This guideline is valid until the end of 2021.

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Section: General Principlesmentioning

confidence: 99%

European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics – Update 2019

Garbe¹,

Amaral

Peris

et al. 2020

European Journal of Cancer

Self Cite

158

161

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show abstract

“…Exclusion criteria were: biopsies obtained for research purposes, indicated for intralesional treatment, performed with the suspicion of metastasis from a neoplasm other than melanoma, or with less than a 4-month follow-up period after the procedure. This time-frame was chosen based on previous publications assessing metastatic disease after an invasive melanoma diagnosis, although slow progressive disease can occur and a longer-term follow-up is preferred ( 11 ).…”

Section: Methodsmentioning

confidence: 99%

Diagnostic Accuracy of Image-guided Biopsies for Diagnosis of Metastatic Melanoma in a Real-life Setting

et al. 2022

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Early detection of melanoma metastasis is essential in order to initiate treatment and improve patient prognosis. The aim of this study was to determine the diagnostic accuracy of different image-guided biopsy techniques in patients with melanoma. A cohort study of patients diagnosed with melanoma who had undergone image-guided biopsies (ultrasound-guided fine-needle aspiration cytology, ultrasound-guided core-needle biopsy, computerized tomography-guided fine-needle aspiration cytology and computerized tomography-guided core-needle biopsy) to detect melanoma metastasis between 2004 and 2021 was conducted. The reference standard was histological confirmation and/or clinical-radiological follow-up. Sensitivity, specificity, positive and negative predictive values were calculated. A total of 600 image-guided biopsies performed on 460 patients were included for analysis. Locoregional lesions represented 459 (76.5%) biopsies, and 141 (23.5%) were distant lesions. Of the included biopsies, 49 (8.2%) were insufficient for diagnosis. Overall, sensitivity and specificity were 92% (95% confidence interval 89–94) and 96% (95% confidence interval 91–99), respectively. Sensitivity sub-analyses revealed lower diagnostic accuracy values in the lung, inguinal lymph nodes, and computerized tomography-guided lesions under 1 cm. Limitations include spontaneous metastasis regression and arbitrary minimum follow-up period. Image-guided biopsies in patients with melanoma have high sensitivity and specificity for detection of regional or distant metastasis. Tissue type, location and tumour burden may influence the diagnostic accuracy of the test.

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“…This cohort study included patients with melanoma seen at Hospital Clinic of Barcelona, Spain from January 1998 through December 2017. All variables were prospectively recorded, following the staging and follow-up protocols, in our centre ( 16 , 17 ). This registry mainly includes patients of Mediterranean origin, living in the Catalonia region.…”

Section: Methodsmentioning

confidence: 99%

Clinicopathological, Genetic and Survival Advantages of Naevus-associated Melanomas: A Cohort Study

Bosch‐Amate¹,

Podlipnik²,

Loughlin³

et al. 2021

Acta Derm Venereol

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Several studies have suggested that naevus-associated melanomas differ from de novo melanomas, being thinner and with less ulceration; however, the prognostic implication is unclear. The objective of this study was to describe clinicopathological, genetic and survival characteristics of de novo and naevus-associated melanomas in a cohort of primary invasive cutaneous melanomas over a 20-year period. Of the 2,227 patients included in the study, 509 (22.86%) had naevus-associated melanomas. Compared with patients with de novo melanoma, they were younger, with a fairer phototype and a higher naevus count, tumours were predominantly the superficial spreading subtype, American Joint Committee on Cancer stage I, located on the trunk, and there were fewer signs of invasiveness (thinner Breslow index, less ulceration, lower mitotic index and less satellitosis). Germline mutational status did not show any significant association. As determined through univariate analysis, overall survival was significantly better in patients with naevus-associated melanoma (hazard ratio 0.64; 95% confidence interval 0.51–0.80, p < 0.001), but multivariate analysis did not support this prognostic indication (hazard ratio 0.94; 95% confidence interval 0.75–1.18, p < 0.606). Despite this, we conclude that naevus-associated and de novo melanomas should be considered as different subtypes of melanoma.

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Diagnostic accuracy of imaging studies for initial staging of T2b to T4b melanoma patients: A cross-sectional study

Cited by 12 publications

References 32 publications

European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics – Update 2019

European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics – Update 2019

Diagnostic Accuracy of Image-guided Biopsies for Diagnosis of Metastatic Melanoma in a Real-life Setting

Clinicopathological, Genetic and Survival Advantages of Naevus-associated Melanomas: A Cohort Study

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