In a study presented today (Wednesday) at the European Cancer Conference (ECCO 14) in Barcelona, scientists found that the less invasive technique produced a false positive rate of only one percent, so that 99 percent of patients with healthy lymph nodes were correctly classified.
The study, the largest of its kind to date, tested the accuracy of the new technique in 590 patients with recently diagnosed melanoma who underwent an ultrasound of the lymph node region near their tumours before having the sentinel lymph node cut out for examination. If the ultrasound confirmed cancer or looked suspicious, patients also underwent the fine needle aspiration biopsy before the sentinel node surgery. Survival was tracked for an average of 28 months.
“The fine needle aspiration detected tumour cells in the lymph node of half of the patients who were later shown to have node-positive disease through the surgical sentinel node biopsy procedure. In nearly all the cases that it missed, the tumour deposit in the sentinel node was very small and those patients seem to have an excellent prognosis – their survival seems similar to that seen in patients with no spread to the lymph nodes,” said the study’s leader, Dr Christiane Voit, a dermatologist and head of the diagnostic unit at the Skin Cancer Center at Charité – Universitätsmedizin Berlin, the Medical University of Berlin, Germany. “This study shows that the technique is highly accurate and we are recommending that it should now be performed routinely before automatically performing sentinel lymph node biopsies, as a way to reduce the need for unnecessary sentinel node operations.”
Whether cancer has spread to the lymph nodes is the most important factor influencing the prognosis and treatment plan for patients with melanoma. Lymph node surgery for tumour staging has become more refined and less debilitating over the last decade. Traditional operations involve the removal of all lymph tissue from the area that drains the site of the tumour, but in some cancers, including melanoma, doctors now more often cut out only one or two key nodes, called sentinel nodes. If the sentinel node is free of cancer, patients don’t need to have more extensive lymph node removal.
However, only 20 percent of patients who have their sentinel lymph nodes excised have cancer that has spread there, so the operation, which can still be accompanied by side effects such as chronic swelling and seroma, is unnecessary for 80 percent of patients.
“Sentinel node biopsy (the excision of only one node instead of all regional lymph nodes) is already an improvement over complete removal of all the lymph nodes in the axilla, groin or neck, but we still need a better way to identify which patients need their sentinel lymph nodes cut out and which don’t, so that all those patients who are subjected to unnecessary surgery can avoid it. Ultrasound-guided fine needle aspiration does look better,” said Voit, adding that the procedure does not cause the side effects seen in sentinel node biopsy. The sometimes-claimed danger of spreading of tumour cells along the needle tract was not evident in this study, nor in previous studies the group has conducted using the method, Voit added.
The technique, called ultrasound-guided fine needle aspiration cytology, or US-FNAC, has been reported to be useful in replacing the need for a sentinel node biopsy in breast cancer, but has not yet been accepted as a valuable option to avoid surgical sentinel node biopsy in melanoma.
Catalogue no: 3BA, Wednesday 12.30 hrs CET (Forum Room)
Emma Ross | alfa
A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg
Urbanization to convert 300,000 km2 of prime croplands
27.12.2016 | Mercator Research Institute on Global Commons and Climate Change (MCC) gGmbH
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).
Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...
Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.
The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...
10.01.2017 | Event News
09.01.2017 | Event News
05.01.2017 | Event News
17.01.2017 | Earth Sciences
17.01.2017 | Materials Sciences
17.01.2017 | Architecture and Construction