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January 16, 2013

SPECT/CT for Sentinel Lymph Node Detection in Patients With Melanoma

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Dermatology Department, CHU Pontchaillou (Dr Dupuy; alain.dupuy@chu-rennes.fr) and Surgery Department, Centre Eugène Marquis (Dr Heusse), Rennes, France.

JAMA. 2013;309(3):232-233. doi:10.1001/jama.2012.88570

To the Editor: Dr Stoffels and colleagues1 evaluated disease-free survival in a series of consecutive patients with melanoma seen in a single center who underwent sentinel lymph node (SLN) excision after preoperative single-photon emission computed tomography/computed tomography (SPECT/CT) detection. A comparison was made to historical controls from the same center who had SLN detection without preoperative SPECT/CT. The SPECT/CT cohort presented with significantly more SLNs detected per patient and a higher number of positive SLNs per patient. Being in the standard cohort rather than in the SPECT/CT cohort was strongly associated with worse disease-free survival (hazard ratio, 4.11; 95% CI, 1.25-13.51) in a multivariate Cox model including SLN status and other important prognostic factors.