Next day sentinel node biopsy for melanoma after lymphoscintigraphy using 99mTc-labelled nanocolloid does not adversely affect long-term outcomes

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Annals of Nuclear Medicine Pub Date : 2024-09-16 DOI:10.1007/s12149-024-01980-y

Amit Roshan, Terouz Pasha, Georgios Kounidas, Suzanne Murphy, Luigi Aloj, John Buscombe, Animesh Patel, Amer Durrani

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引用次数: 0

Abstract

Objective

Sentinel Lymph Node Biopsy (SLNB) is an important management tool for early-stage melanoma. Different radiopharmaceuticals are used internationally to localise the sentinel node using lymphoscintigraphy (LSG) before surgery. Recent reports have suggested that a delayed interval between LSG and SLNB using ^99mTc-labelled nanocolloid tracer has an adverse survival impact, but not with ^99mTc-labelled antimony sulphide colloid. This study aims to analyse survival outcome in a prospective cohort of melanoma patients undergoing same day or next day SLNB after LSG using ^99mTc-labelled nanocolloid.

Methods

Outcome data were reviewed for patients undergoing SLNB, stratified by time interval between LSG and SLNB at a single UK academic centre. Kaplan–Meier survival analysis was used to assess overall survival (OS), melanoma-specific survival (MSS) and progression-free survival (PFS). Cox multivariable regression analysis identified independent risk factors.

Results

925 patients had LSG using the ^99mTc-nanocolloid tracer between 2009 and 2019, with a median follow-up of 6.36 years. No difference was seen on univariate analysis in OS, MSS, PFS, or nodal recurrence between patients undergoing same day or next day SLNB (Log-rank P = 0.437, 0.293, 0.587, 0.342 respectively). In addition, nodal recurrence as first site or anytime site of recurrence in SLNB negative patients was similar between the groups (Log-rank P = 0.093 and 0.457 respectively). Stratified analysis of time did not demonstrate an outcome difference (MSS Log-rank P = 0.938). Cox multivariable regression did not show time interval to independently influence OS, MSS or PFS.

Conclusions

We do not find a significant effect on long-term outcomes when SLNB is performed the day after LSG with ^99mTc-labelled nanocolloid tracer. We infer that tracer migration is not clinically significant within 24 h of injection based on long term clinical outcome data.

Abstract Image

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使用 99mTc 标记的纳米胶体进行淋巴管造影后第二天进行黑色素瘤前哨节点活检不会对长期疗效产生不利影响

目的前哨淋巴结活检（SLNB）是早期黑色素瘤的重要治疗手段。国际上使用不同的放射性药物在手术前通过淋巴管造影（LSG）对前哨淋巴结进行定位。最近有报告指出，使用 99mTc 标记的纳米胶体示踪剂时，LSG 和 SLNB 之间的延迟间隔会对生存产生不利影响，而使用 99mTc 标记的硫化锑胶体时则不会。本研究旨在分析前瞻性黑色素瘤患者队列中使用 99mTc 标记的纳米胶体进行 LSG 后当天或次日 SLNB 的生存结果。Kaplan-Meier 生存分析用于评估总生存期（OS）、黑色素瘤特异性生存期（MSS）和无进展生存期（PFS）。结果 2009年至2019年期间，925名患者使用99m锝-纳米胶体示踪剂进行了LSG治疗，中位随访时间为6.36年。单变量分析显示，当日或次日接受SLNB的患者在OS、MSS、PFS或结节复发方面没有差异（Log-rank P = 0.437、0.293、0.587、0.342）。此外，在 SLNB 阴性患者中，结节复发作为第一复发部位或随时复发部位的情况在各组之间相似（Log-rank P = 0.093 和 0.457）。时间分层分析未显示结果差异（MSS Log-rank P = 0.938）。结论我们没有发现使用 99mTc 标记的纳米胶体示踪剂在 LSG 后第二天进行 SLNB 会对长期结果产生显著影响。根据长期临床结果数据，我们推断示踪剂迁移在注射后 24 小时内没有临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Nuclear Medicine 医学-核医学

CiteScore

4.90

自引率

7.70%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.