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Ultrasound Patterns signals can be used as a predictive tool in the diagnosis and treatment planning for melanoma patients, the study presented at the ESMO/ECCO Multidisciplinary Congress in Berlin. Christiane Voit, MD, a dermatologist and head of the diagnostic unit at the Skin Cancer Centre at Charite, and her colleagues conducted a study to show how far ultrasound patterns correlate with disease progression, tumor burden, survival, and prognosis in the first 400 of 850 patients with stage I/II melanoma and with the longest follow-up.

The results of the study revealed that 2 ultrasound patterns together could correctly identify the amount of cancer cells in the lymph nodes in 80% of cases.

The first pattern, a balloon-shape ultrasound pattern with or without loss of central echoes, was an indicator in up to 83% of cases of a larger amount of cancer cells in the sentinel node. According to Dr Voit, this pattern was a late sign, only occurring in cases of advanced metastasis. The second pattern, a pattern of peripheral perfusion, was an early sign of a small number of cancer cells present. “The early signs are signs of first disruption of the normal lymph node architecture by an early state metastasis. The most important one is peripheral perfusion, which shows angiogenesis is occurring,” Dr Voit explained.

Overall, the estimates for survival after 5 years for patients with stage I/II was between 50% and 90% depending on the stage of the tumor. Dr Voit found that 93% of patients with neither of these ultrasound patterns, 87% of patients with peripheral perfusion, and 56% of patients with balloon shapes with or without loss of central echoes survived for at least 5 years; survival without cancer spreading to other parts of the body was 74%, 60%, and 26%, respectively.

“For the first time we have established that ultrasound patterns can be used as criteria for diagnosing disease progression and tumor burden. Balloon-shaped lymph nodes with or without loss of central echoes and peripheral perfusion are independent prognostic factors for survival,” Dr Voit added.

Source: AJHO

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