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Ultrasound may predict metastases, survival in melanoma

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ECCO 15 – ESMO 34 Multidisciplinary Congress

Patterns of ultrasound signals may help identify whether or not cancer has metastasized and to what extent and may also help with decisions about surgery, according to the findings from a prospective study.

Christiane Voit, MD, PhD, head of the diagnostic unit at the Skin Cancer Center at the Medical University of Berlin, presented findings from a study that included 850 patients with stage I or II melanoma, at the ECCO 15 –ESMO 34 Multidisciplinary Congress, held in Berlin.

“We have identified two ultrasound patterns of lymph node metastasis in melanoma patients, which can identify correctly any amount of tumor cells in the sentinel lymph nodes in 75% to 90% of cases before proceeding to surgery on the sentinel lymph nodes,” Voit said in a press release.

Two ultrasound patterns used together correctly identified the amount of cancer cells in the lymph nodes in 80% of cases, according to the researchers.

In 83% of cases of a large amount of cancer cells in the sentinel node, a balloon-shaped ultrasound pattern with or without loss of central echoes was observed. The pattern only occurred in advanced cases of metastasis, according to Voit.

A pattern of peripheral perfusion, with small blood vessels surrounding the lymph node, was an indicator of a small number of cancer cells.

The two patterns also helped predict survival, according to the researchers. For OS, 93% of patients with neither ultrasound pattern survived for five or more years. Fewer patients with the peripheral perfusion pattern (87%) and the balloon-shaped pattern (56%) survived five or more years.

“For the first time we have established that ultrasound patterns can be used as criteria for diagnosing disease progression and tumor burden,” Voit said.

Voit said the data need to be confirmed in multicenter, randomized clinical trials, but could lead to a means for potentially sparing patients from unnecessary surgery.

For more information:

• Voit C. #9303. Presented at: ECCO 15 – 34th ESMO Multidisciplinary Congress; Sept. 20-24, 2009; Berlin.

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