Amit Roshan, Terouz Pasha, Georgios Kounidas, Suzanne Murphy, Luigi Aloj, John Buscombe, Animesh Patel, Amer Durrani
{"title":"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","authors":"Amit Roshan, Terouz Pasha, Georgios Kounidas, Suzanne Murphy, Luigi Aloj, John Buscombe, Animesh Patel, Amer Durrani","doi":"10.1007/s12149-024-01980-y","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>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 <sup>99m</sup>Tc-labelled nanocolloid tracer has an adverse survival impact, but not with <sup>99m</sup>Tc-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 <sup>99m</sup>Tc-labelled nanocolloid.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>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.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>925 patients had LSG using the <sup>99m</sup>Tc-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 <i>P</i> = 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 <i>P</i> = 0.093 and 0.457 respectively). Stratified analysis of time did not demonstrate an outcome difference (MSS Log-rank <i>P</i> = 0.938). Cox multivariable regression did not show time interval to independently influence OS, MSS or PFS.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>We do not find a significant effect on long-term outcomes when SLNB is performed the day after LSG with <sup>99m</sup>Tc-labelled nanocolloid tracer. We infer that tracer migration is not clinically significant within 24 h of injection based on long term clinical outcome data.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Next day sentinel node biopsy for melanoma after lymphoscintigraphy using 99mTc-labelled nanocolloid does not adversely affect long-term outcomes\",\"authors\":\"Amit Roshan, Terouz Pasha, Georgios Kounidas, Suzanne Murphy, Luigi Aloj, John Buscombe, Animesh Patel, Amer Durrani\",\"doi\":\"10.1007/s12149-024-01980-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Objective</h3><p>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 <sup>99m</sup>Tc-labelled nanocolloid tracer has an adverse survival impact, but not with <sup>99m</sup>Tc-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 <sup>99m</sup>Tc-labelled nanocolloid.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>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.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>925 patients had LSG using the <sup>99m</sup>Tc-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 <i>P</i> = 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 <i>P</i> = 0.093 and 0.457 respectively). Stratified analysis of time did not demonstrate an outcome difference (MSS Log-rank <i>P</i> = 0.938). Cox multivariable regression did not show time interval to independently influence OS, MSS or PFS.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusions</h3><p>We do not find a significant effect on long-term outcomes when SLNB is performed the day after LSG with <sup>99m</sup>Tc-labelled nanocolloid tracer. 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Next day sentinel node biopsy for melanoma after lymphoscintigraphy using 99mTc-labelled nanocolloid does not adversely affect long-term outcomes
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.
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.
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