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.
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
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.
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U2 - 10.1001/archderm.134.5.569
DO - 10.1001/archderm.134.5.569
M3 - Article
C2 - 9606326
AN - SCOPUS:0031922591
SN - 0003-987X
VL - 134
SP - 569
EP - 572
JO - Archives of Dermatology
JF - Archives of Dermatology
IS - 5
ER -