8582 Background: Positron emission tomography (PET) scanning is increasingly used for the staging and management of malignant melanoma. The role of PET as a routine procedure in patients with positive sentinel node biopsy (SNB) is not yet established. We report in the series with longest follow up outcomes of PET scans performed in patients with subclinical lymph node disease. Methods: Case notes of 29 sequential patients with melanoma of Breslow thickness greater than 1mm who had PET scans within 130 days after a positive SNB were reviewed. Four patients had a PET after the lymph node dissection (LND). Results: 2 patients (6%) had a positive PET scan neither of which was melanoma related. The first patient had a thyroid tumour confirmed with fine needle aspiration biopsy and the second patient had increased uptake in the chest wall which on verification with bone scan proved to be old trauma. 28 patients (96%) had a LND and this was positive in 5 cases (17%). With a median follow up of 23 months 21 patients remained disease free. Out of the 8 patients (27%) who presented with recurrence 2 (25%) were successfully treated with further surgery and remained in remission, 4 (50%) died, 1 (12.5%) was lost from follow-up and 1 (12.5%) is followed up in another hospital. In none of the 29 cases did the early PET scan after a positive SNB alter subsequent melanoma management. Conclusions: The role of PET scanning soon after a positive sentinel node biopsy appears to be of uncertain benefit. It is questionable whether any imaging is beneficial at this stage. The results of this review suggest that PET scanning might not be indicated for this group of patients but larger prospective studies are required to confirm this. Patients Characteristics No % Male 15 (51) Female 14 (49) Melanoma Type: Nodular 8 (27) Superficial spreading 15 (51) Other 2 (6) Unknown 4 (13) Breslow thickness: 1.0–1.9 13 (44) 2.00–3.9 14 (49) ○= 4.0 2 (6) Ulceration: Yes 3 (10) No 25 (86) Unknown 1 (3) Age Median 56 No significant financial relationships to disclose.
Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy
