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Related Concept Videos

Skin Cancer01:30

Skin Cancer

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Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...
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Related Experiment Video

Updated: Jun 6, 2025

A 3D Organotypic Melanoma Spheroid Skin Model
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A 3D Organotypic Melanoma Spheroid Skin Model

Published on: May 18, 2018

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High-Risk Melanoma: Stage Before Operating.

Stanislau Makaranka1, Zon Oo1, Jonathan Pollock1

  • 1Department of Plastic Surgery, Nottingham University Hospitals NHS FT, Nottingham, UK.

Pigment Cell & Melanoma Research
|December 3, 2024
PubMed
Summary

For high-risk melanoma, axial imaging before sentinel lymph node biopsy (SLNB) revealed frequent management-changing findings. This supports a

Area of Science:

  • Oncology
  • Dermatology
  • Radiology

Background:

  • Current National Institute for Health and Care Excellence (NICE) guidelines recommend against routine pre-operative imaging for high-risk melanoma patients before sentinel lymph node biopsy (SLNB).
  • This approach is reserved for cases where lymph node or distant metastases are already suspected.

Discussion:

  • Retrospective analysis of patients with pT3b, pT4a, and pT4b melanomas demonstrated a high incidence of management-altering findings on axial imaging prior to SLNB.
  • The findings suggest that a 'stage before operating' strategy, incorporating comprehensive axial imaging, is beneficial for these high-risk melanoma cases.
  • This challenges the current NICE guideline by advocating for proactive staging in specific high-risk melanoma subgroups.

Key Insights:

  • Pre-SLNB axial imaging in high-risk melanoma (pT3b, pT4a, pT4b) frequently identifies actionable findings.

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  • The 'stage before operating' paradigm is supported by the high rate of management changes observed.
  • This data supports a revised approach to staging in advanced melanoma.

    • Outlook:

    • Consideration for revising current NICE guidelines regarding pre-SLNB imaging in high-risk melanoma.
    • Potential for improved patient management and treatment planning through routine pre-operative staging.
    • Encouraging multidisciplinary teams (MDTs) to adopt comprehensive axial imaging for high-risk melanoma staging.