(HealthDay News) – For patients with clinically lymph node-negative melanoma, the use of single-photon emission computed tomography/computed tomography (SPECT/CT) to aid sentinel lymph node excision (SLNE) is associated with increased detection of metastatic involvement and improved disease-free survival, compared with standard SLNE, according to a study published in the Sept 12 issue of the Journal of the American Medical Association.

Ingo Stoffels, MD, from the University of Essen-Duisburg in Germany, and colleagues compared metastatic node detection and disease-free survival using SPECT/CT-aided SLNE versus standard SLNE in a cohort of 403 patients with melanoma with clinically negative lymph nodes.

A total of 254 patients underwent the standard SLNE technique and 149 underwent SPECT/CT-aided SLNE. The researchers found that use of SPECT/CT allowed SLNE more frequently in the head and neck area (2% for standard versus 23.5% for SPECT/CT; P<0.001). More sentinel lymph nodes per patient were detected in the SPECT/CT cohort than in the standard cohort (2.4 vs. 1.87; P<0.001), and the number of positive sentinel lymph nodes per patient was significantly higher (0.34 vs. 0.21; P=0.04). In the SPECT/CT cohort, the local relapse rate was significantly lower (6.8 vs. 23.8%; P=0.03) and four-year disease-free survival was significantly higher (93.9 vs. 79.2%; P=0.02), compared to the standard cohort.

“Among patients with clinically lymph node-negative melanoma, the use of SPECT/CT-aided SLNE compared with SLNE alone was associated with a higher frequency of metastatic involvement and a higher rate of disease-free survival,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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