Evidence map›Paper›PMID 33609385›Full record

ArticleBJS open2021

CT diagnosis of ilioinguinal lymph node metastases in melanoma using radiological characteristics beyond size and asymmetry.

M J Wilkinson, H Snow, K Downey, K Thomas, A Riddell, N Francis, D C Strauss, A J Hayes, M J F Smith, C Messiou

Open access · goldAbstract read
In one paragraph

Article in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.1field-weighted citation impact, top 58% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

M J WilkinsonDepartment of Academic Surgery, Sarcoma and Melanoma Unit, The Royal Marsden Hospital, London, UK.
H SnowDepartment of Academic Surgery, Sarcoma and Melanoma Unit, The Royal Marsden Hospital, London, UK.
K DowneyDepartment of Radiology, The Royal Marsden Hospital, London, UK.
K ThomasStatistics Department, The Royal Marsden Hospital, London, UK.
A RiddellDepartment of Radiology, The Royal Marsden Hospital, London, UK.
N FrancisDepartment of Pathology, The Royal Marsden Hospital (Honorary) and Charing Cross Hospital, London, UK.
D C StraussDepartment of Academic Surgery, Sarcoma and Melanoma Unit, The Royal Marsden Hospital, London, UK.
A J HayesDepartment of Academic Surgery, Sarcoma and Melanoma Unit, The Royal Marsden Hospital, London, UK.
M J F SmithDepartment of Academic Surgery, Sarcoma and Melanoma Unit, The Royal Marsden Hospital, London, UK.
C MessiouDepartment of Radiology, The Royal Marsden Hospital, London, UK.
Royal Marsden Hospital · GBInstitute of Cancer Research · GBCharing Cross Hospital · GB

Funding

Cancer Research UKDepartment of Health C1060/A10334Department of Health C1060/A16464Medical Research Council
6 · The paper itself

Abstract

backgroundDiagnosis of lymph node (LN) metastasis in melanoma with non-invasive methods is challenging. The aim of this study was to evaluate the diagnostic accuracy of six LN characteristics on CT in detecting melanoma-positive ilioinguinal LN metastases, and to determine whether inguinal LN characteristics can predict pelvic LN involvement.

methodsThis was a single-centre retrospective study of patients with melanoma LN metastases at a tertiary cancer centre between 2008 and 2016. Patients who had preoperative contrast-enhanced CT assessment and ilioinguinal LN dissection were included. CT scans containing significant artefacts obscuring the pelvis were excluded. CT scans were reanalysed for six LN characteristics (extracapsular spread (ECS), minimum axis (MA), absence of fatty hilum (FH), asymmetrical cortical nodule (CAN), abnormal contrast enhancement (ACE) and rounded morphology (RM)) and compared with postoperative histopathological findings.

resultsA total of 90 patients were included. Median age was 58 (range 23-85) years. Eighty-eight patients (98 per cent) had pathology-positive inguinal disease and, of these, 45 (51 per cent) had concurrent pelvic disease. The most common CT characteristics found in pathology-positive inguinal LNs were MA greater than 10 mm (97 per cent), ACE (80 per cent), ECS (38 per cent) and absence of RM (38 per cent). In multivariable analysis, inguinal LN characteristics on CT indicative of pelvic disease were RM (odds ratio (OR) 3.3, 95 per cent c.i. 1.2 to 8.7) and ECS (OR 4.2, 1.6 to 11.3). Cloquet's node is known to be a poor predictor of pelvic spread. Pelvic LN disease was present in 50 per cent patients, but only 7 per cent had a pathology-positive Cloquet's node.

conclusionAdditional CT radiological characteristics, especially ECS and RM, may improve diagnostic accuracy and aid clinical decisions regarding the need for inguinal or ilioinguinal dissection.

Indexed as

Tomography, X-Ray ComputedAdultAgedAged, 80 and overFemaleGroinHumansLogistic ModelsLymphatic MetastasisLymph Node ExcisionLymph NodesMaleMelanomaMiddle AgedPelvisRetrospective Studies

Identifiers

PMID33609385
PMCPMC7893466
OpenAlexW3126048114

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.