Use of chest radiography in the initial evaluation of patients with localized melanoma

Margaret H. Terhune, Neil Swanson, Timothy M. Johnson

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Objective: To evaluate the use of an initial staging chest x-ray film in asymptomatic patients who present with localized primary cutaneous melanoma. Designs: 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.

Original languageEnglish (US)
Pages (from-to)569-572
Number of pages4
JournalArchives of Dermatology
Volume134
Issue number5
DOIs
StatePublished - 1998

Fingerprint

Radiography
Melanoma
Thorax
Motion Pictures
X-Rays
Neoplasm Metastasis
Lung
Databases
Referral and Consultation
Outcome Assessment (Health Care)
Prospective Studies
Skin

ASJC Scopus subject areas

  • Dermatology

Cite this

Use of chest radiography in the initial evaluation of patients with localized melanoma. / Terhune, Margaret H.; Swanson, Neil; Johnson, Timothy M.

In: Archives of Dermatology, Vol. 134, No. 5, 1998, p. 569-572.

Research output: Contribution to journalArticle

Terhune, Margaret H. ; Swanson, Neil ; Johnson, Timothy M. / Use of chest radiography in the initial evaluation of patients with localized melanoma. In: Archives of Dermatology. 1998 ; Vol. 134, No. 5. pp. 569-572.
@article{6c522f4e7a0f4f4f990133939fa63ac1,
title = "Use of chest radiography in the initial evaluation of patients with localized melanoma",
abstract = "Objective: To evaluate the use of an initial staging chest x-ray film in asymptomatic patients who present with localized primary cutaneous melanoma. Designs: 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.",
author = "Terhune, {Margaret H.} and Neil Swanson and Johnson, {Timothy M.}",
year = "1998",
doi = "10.1001/archderm.134.5.569",
language = "English (US)",
volume = "134",
pages = "569--572",
journal = "JAMA Dermatology",
issn = "2168-6068",
publisher = "American Medical Association",
number = "5",

}

TY - JOUR

T1 - Use of chest radiography in the initial evaluation of patients with localized melanoma

AU - Terhune, Margaret H.

AU - Swanson, Neil

AU - Johnson, Timothy M.

PY - 1998

Y1 - 1998

N2 - Objective: To evaluate the use of an initial staging chest x-ray film in asymptomatic patients who present with localized primary cutaneous melanoma. Designs: 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.

AB - Objective: To evaluate the use of an initial staging chest x-ray film in asymptomatic patients who present with localized primary cutaneous melanoma. Designs: 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.

UR - http://www.scopus.com/inward/record.url?scp=0031922591&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031922591&partnerID=8YFLogxK

U2 - 10.1001/archderm.134.5.569

DO - 10.1001/archderm.134.5.569

M3 - Article

C2 - 9606326

AN - SCOPUS:0031922591

VL - 134

SP - 569

EP - 572

JO - JAMA Dermatology

JF - JAMA Dermatology

SN - 2168-6068

IS - 5

ER -