@jms0104
Forum Replies Created
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- November 16, 2016 at 2:02 pm
Always great to hear updates like these. I suspect most who go NED don't bother to post, but glad you took the time and very happy to hear of Doug's continued NED status. The statician in me would venture to guess that his odds of recurrence continue to diminish with time which is also great news.
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- November 16, 2016 at 2:02 pm
Always great to hear updates like these. I suspect most who go NED don't bother to post, but glad you took the time and very happy to hear of Doug's continued NED status. The statician in me would venture to guess that his odds of recurrence continue to diminish with time which is also great news.
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- November 16, 2016 at 2:02 pm
Always great to hear updates like these. I suspect most who go NED don't bother to post, but glad you took the time and very happy to hear of Doug's continued NED status. The statician in me would venture to guess that his odds of recurrence continue to diminish with time which is also great news.
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- November 20, 2016 at 2:44 pm
Niki, thanks for your reply. I enjoyed reading your blog and am inspired by your fight. How have your recent scans been? You've hit on the issue I'm having trouble accepting…what can I do to stop future spread (if anything at all?). SNB doesn't sound useful in thin melanomas especially considering your case. Appears like you did nearly everything right yet still ended up with metastasis.
Jay
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- November 20, 2016 at 2:44 pm
Niki, thanks for your reply. I enjoyed reading your blog and am inspired by your fight. How have your recent scans been? You've hit on the issue I'm having trouble accepting…what can I do to stop future spread (if anything at all?). SNB doesn't sound useful in thin melanomas especially considering your case. Appears like you did nearly everything right yet still ended up with metastasis.
Jay
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- November 20, 2016 at 2:44 pm
Niki, thanks for your reply. I enjoyed reading your blog and am inspired by your fight. How have your recent scans been? You've hit on the issue I'm having trouble accepting…what can I do to stop future spread (if anything at all?). SNB doesn't sound useful in thin melanomas especially considering your case. Appears like you did nearly everything right yet still ended up with metastasis.
Jay
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- November 19, 2016 at 2:26 am
Thanks Janner. However, the studies I've read don't indicate much of a problem doing the SNB post WLE.
Sentinel lymph-node biopsy after previous wide local excision for melanoma.
Abstract
OBJECTIVE:
To document experience with sentinel lymph-node biopsy in patients who have already undergone a wide local excision for melanoma because in many centres previous wide excision has been a contraindication for sentinel lymph-node biopsy. DESIGN:
A prospective cohort study. SETTING:
A tertiary care academic cancer centre. PATIENTS:
One hundred patients who presented with cutaneous melanoma (depth >1 mm or Clark level IV) after having undergone wide local excision of the primary lesion that was not situated in the head or neck. The follow-up was 3 years. INTERVENTIONS:
Sentinel lymph-node biopsy. Patients with truncal melanoma had preoperative lymphoscintigraphy to document the nodal basins at risk. Technetium-99m sulfur colloid (0.5-1 mCi in 0.5 mL) was injected intradermally around the scar, and the sentinel lymph node was excised with the aid of a hand-held gamma detector. OUTCOME MEASURES:
Accuracy of the biopsy and false-negative rates in this setting. RESULTS:
Of the 100 patients, 44 had truncal and 56 had extremity lesions. The average tumour depth was 3.47 mm and 3.07 mm respectively. Thirty-one patients had a sentinel lymph node positive for melanoma metastasis. Biopsies were positive for melanoma in 18 (41%) truncal lesions and 13 (23%) extremity lesions. There were 3 (9%) false-negative sentinel lymph-node biopsies as diagnosed by clinically evident nodal disease subsequently appearing in the nodal basin subjected to biopsy. Two occurred in patients after large rotation flap closures of truncal lesions. The third patient had a subungual melanoma of the great toe. No disease was found in the 2 nodes dissected. Two of the 3 false-negative biopsy results were obtained before serial sections and immunohistochemical staining were used to examine the sentinel lymph nodes. CONCLUSIONS:
Sentinel lymph-node biopsies can successfully identify clinically occult nodal metastases in patients who have had previous wide local excision of a melanoma, but the false-negative rate in patients with rotation flap closures should be taken into consideration. -
- November 19, 2016 at 2:26 am
Thanks Janner. However, the studies I've read don't indicate much of a problem doing the SNB post WLE.
Sentinel lymph-node biopsy after previous wide local excision for melanoma.
Abstract
OBJECTIVE:
To document experience with sentinel lymph-node biopsy in patients who have already undergone a wide local excision for melanoma because in many centres previous wide excision has been a contraindication for sentinel lymph-node biopsy. DESIGN:
A prospective cohort study. SETTING:
A tertiary care academic cancer centre. PATIENTS:
One hundred patients who presented with cutaneous melanoma (depth >1 mm or Clark level IV) after having undergone wide local excision of the primary lesion that was not situated in the head or neck. The follow-up was 3 years. INTERVENTIONS:
Sentinel lymph-node biopsy. Patients with truncal melanoma had preoperative lymphoscintigraphy to document the nodal basins at risk. Technetium-99m sulfur colloid (0.5-1 mCi in 0.5 mL) was injected intradermally around the scar, and the sentinel lymph node was excised with the aid of a hand-held gamma detector. OUTCOME MEASURES:
Accuracy of the biopsy and false-negative rates in this setting. RESULTS:
Of the 100 patients, 44 had truncal and 56 had extremity lesions. The average tumour depth was 3.47 mm and 3.07 mm respectively. Thirty-one patients had a sentinel lymph node positive for melanoma metastasis. Biopsies were positive for melanoma in 18 (41%) truncal lesions and 13 (23%) extremity lesions. There were 3 (9%) false-negative sentinel lymph-node biopsies as diagnosed by clinically evident nodal disease subsequently appearing in the nodal basin subjected to biopsy. Two occurred in patients after large rotation flap closures of truncal lesions. The third patient had a subungual melanoma of the great toe. No disease was found in the 2 nodes dissected. Two of the 3 false-negative biopsy results were obtained before serial sections and immunohistochemical staining were used to examine the sentinel lymph nodes. CONCLUSIONS:
Sentinel lymph-node biopsies can successfully identify clinically occult nodal metastases in patients who have had previous wide local excision of a melanoma, but the false-negative rate in patients with rotation flap closures should be taken into consideration. -
- November 19, 2016 at 2:26 am
Thanks Janner. However, the studies I've read don't indicate much of a problem doing the SNB post WLE.
Sentinel lymph-node biopsy after previous wide local excision for melanoma.
Abstract
OBJECTIVE:
To document experience with sentinel lymph-node biopsy in patients who have already undergone a wide local excision for melanoma because in many centres previous wide excision has been a contraindication for sentinel lymph-node biopsy. DESIGN:
A prospective cohort study. SETTING:
A tertiary care academic cancer centre. PATIENTS:
One hundred patients who presented with cutaneous melanoma (depth >1 mm or Clark level IV) after having undergone wide local excision of the primary lesion that was not situated in the head or neck. The follow-up was 3 years. INTERVENTIONS:
Sentinel lymph-node biopsy. Patients with truncal melanoma had preoperative lymphoscintigraphy to document the nodal basins at risk. Technetium-99m sulfur colloid (0.5-1 mCi in 0.5 mL) was injected intradermally around the scar, and the sentinel lymph node was excised with the aid of a hand-held gamma detector. OUTCOME MEASURES:
Accuracy of the biopsy and false-negative rates in this setting. RESULTS:
Of the 100 patients, 44 had truncal and 56 had extremity lesions. The average tumour depth was 3.47 mm and 3.07 mm respectively. Thirty-one patients had a sentinel lymph node positive for melanoma metastasis. Biopsies were positive for melanoma in 18 (41%) truncal lesions and 13 (23%) extremity lesions. There were 3 (9%) false-negative sentinel lymph-node biopsies as diagnosed by clinically evident nodal disease subsequently appearing in the nodal basin subjected to biopsy. Two occurred in patients after large rotation flap closures of truncal lesions. The third patient had a subungual melanoma of the great toe. No disease was found in the 2 nodes dissected. Two of the 3 false-negative biopsy results were obtained before serial sections and immunohistochemical staining were used to examine the sentinel lymph nodes. CONCLUSIONS:
Sentinel lymph-node biopsies can successfully identify clinically occult nodal metastases in patients who have had previous wide local excision of a melanoma, but the false-negative rate in patients with rotation flap closures should be taken into consideration.
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