{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:24:16Z","timestamp":1779895456924,"version":"3.53.1"},"reference-count":39,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"30","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2009,10,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Sentinel node (SN) status is the most important prognostic factor for overall survival (OS) for patients with stage I\/II melanoma, and the role of the SN procedure as a staging procedure has long been established. However, a less invasive procedure, such as ultrasound (US) -guided fine-needle aspiration cytology (FNAC), would be preferred. The aim of this study was to evaluate the accuracy of US-guided FNAC and compare the results with histology after SN surgery was performed in all patients. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Four hundred consecutive patients who underwent lymphoscintigraphy subsequently underwent a US examination before the SN procedure. When the US examination showed a suspicious or malignant pattern, patients underwent an FNAC. Median Breslow thickness was 1.8 mm; mean follow-up was 42 months (range, 4 to 82 months). We considered the US-guided FNAC positive if either US and\/or FNAC were positive. If US was suggestive of abnormality, but FNAC was negative, the US-guided FNAC was considered negative. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> US-guided FNAC identified 51 (65%) of 79 SN metastases. Specificity was 99% (317 of 321), with a positive predictive value of 93% and negative predictive value of 92%. SN-positive identification rate by US-guided FNAC increased from 40% in stage pT1a\/b disease to 79% in stage pT4a\/b disease. US-guided FNAC detected SN tumors more than 1.0 mm in 86% of cases, SN tumors of 0.1 to 1.0 mm in 46% of cases, and SN tumors less than 0.1 mm in 23% of cases. Estimated 5-year OS rates were 92% for patients with negative US-guided FNAC results and 51% for patients with positive results. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> US-guided FNAC of SNs is highly accurate. Up to 65% of the patients with SN-positive results in our institution could have been spared an SN procedure. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2008.19.0033","type":"journal-article","created":{"date-parts":[[2009,9,9]],"date-time":"2009-09-09T02:19:23Z","timestamp":1252462763000},"page":"4994-5000","source":"Crossref","is-referenced-by-count":95,"title":["Rotterdam Criteria for Sentinel Node (SN) Tumor Burden and the Accuracy of Ultrasound (US) -Guided Fine-Needle Aspiration Cytology (FNAC): Can US-Guided FNAC Replace SN Staging in Patients With Melanoma?"],"prefix":"10.1200","volume":"27","author":[{"given":"Christiane A.","family":"Voit","sequence":"first","affiliation":[{"name":"From the Department of Dermatology, Charit\u00e9, Humboldt University, Berlin; Department of Medical Oncology, Armed Forces Hospital, University of Ulm, Ulm, Germany; and Departments of Surgical Oncology and Statistics, Erasmus University Medical Center\u2013Daniel den Hoed Cancer Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander C.J.","family":"van Akkooi","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, Charit\u00e9, Humboldt University, Berlin; Department of Medical Oncology, Armed Forces Hospital, University of Ulm, Ulm, Germany; and Departments of Surgical Oncology and Statistics, Erasmus University Medical Center\u2013Daniel den Hoed Cancer Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Sch\u00e4fer-Hesterberg","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, Charit\u00e9, Humboldt University, Berlin; Department of Medical Oncology, Armed Forces Hospital, University of Ulm, Ulm, Germany; and Departments of Surgical Oncology and Statistics, Erasmus University Medical Center\u2013Daniel den Hoed Cancer Center, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Schoengen","sequence":"additional","affiliation":[{"name":"From the Department of Dermatology, Charit\u00e9, Humboldt University, Berlin; Department of Medical Oncology, Armed Forces Hospital, University of Ulm, Ulm, Germany; 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