Use of Chest Radiography in the Initial Evaluation of Patients With Localized Melanoma
Margaret H. Terhune, MD;
Neil Swanson, MD;
Timothy M. Johnson, MD
Arch Dermatol. 1998;134:569-572.
Objective To evaluate the use of an initial staging chest x-ray film in asymptomatic patients who present with localized primary cutaneous melanoma.
Design The staging workup of 1032 consecutive asymptomatic patients with localized melanoma was retrospectively reviewed via database chart review.
Setting Regional melanoma referral center in an academic medical center.
Patients The melanoma database identified 1032 asymptomatic patients with localized melanoma for retrospective review. Of the patients studied, 876 (85%) of 1032 had an initial staging chest x-ray film performed. A chest x-ray film was considered initial if performed within 6 months of melanoma diagnosis.
Main Outcome Measure The rate of positive, negative, and suspicious findings of initial chest x-ray films.
Results One hundred thirty (15%) of 876 patients had suspicious findings necessitating additional workup. Based on follow-up radiologic findings, only 1 (0.1%) of 876 had a true-positive chest x-ray film demonstrating pulmonary metastasis.
Conclusions The yield of detection of unsuspected pulmonary metastasis by chest x-ray film in the initial evaluation of asymptomatic patients with localized melanoma was exceedingly low (0.1%). Our results support the concept that routine chest radiograph screening in asymptomatic patients presenting with stage I and intermediate-thickness (1.5- to 4.0-mm) stage II melanoma is unlikely to yield true-positive findings of silent pulmonary metastasis. No definitive conclusions were drawn for the subset of patients with stage II thick melanoma (>4.0 mm) because of the small number of patients (n = 40) in our series. Prospective studies are necessary to ultimately define the yield of initial radiographs in asymptomatic patients with localized melanoma.
From the Departments of Dermatology, Otolaryngology, and Surgery (Division of Plastic Surgery), University of Michigan Medical Center and Comprehensive Cancer Center, Ann Arbor. Dr Terhune is now with the University of Kentucky, Lexington. Dr Swanson is now with the Oregon Health Sciences Center, Portland.
RELATED ARTICLE
Initial Evaluation of Melanoma: Don't Stop Getting That Chest X-ray . . . Yet
Edward A. Gross
Arch Dermatol. 1998;134(5):623-624.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Utility of Computed Tomography and Magnetic Resonance Imaging Staging Before Completion Lymphadenectomy in Patients With Sentinel Lymph Node-Positive Melanoma
Aloia et al.
JCO 2006;24:2858-2865.
ABSTRACT
| FULL TEXT
Management of Cutaneous Melanoma
Tsao et al.
NEJM 2004;351:998-1012.
FULL TEXT
Early Detection of Asymptomatic Pulmonary Melanoma Metastases by Routine Chest Radiographs Is Not Associated With Improved Survival
Tsao et al.
Arch Dermatol 2004;140:67-70.
ABSTRACT
| FULL TEXT
Staging Workup, Sentinel Node Biopsy, and Follow-up Tests for Melanoma: Update of Current Concepts
Johnson et al.
Arch Dermatol 2004;140:107-113.
ABSTRACT
| FULL TEXT
Comparison of Positron Emission Tomography Scanning and Sentinel Node Biopsy in the Detection of Micrometastases of Primary Cutaneous Malignant Melanoma
Acland et al.
JCO 2001;19:2674-2678.
ABSTRACT
| FULL TEXT
Rational Follow-up Recommendations for Patients With Melanoma
Chartier and Bigby
Arch Dermatol 2000;136:1145-1148.
FULL TEXT
Initial Evaluation of Melanoma: Don't Stop Getting That Chest X-ray . . . Yet.
Kanzler
Arch Dermatol 1999;135:1121-1122.
FULL TEXT
Initial Evaluation of Melanoma: Don't Stop Getting That Chest X-ray . . . Yet
Gross
Arch Dermatol 1998;134:623-624.
FULL TEXT
|
