Improvement of Ultrasound Diagnosis of Regional Lymph Nodes in Skin Melanoma: Development of the Russian Classification (RUCL-M) to Reduce Hyperdiagnostics and Unjustified Biopsies.

Purpose : To improve ultrasound diagnostics of regional lymph nodes in skin melanoma: to develop a new Russian ultrasound classification of regional lymph nodes in melanoma (RUCL-M) to reduce hyperdiagnosis and reduce the number of unjustified biopsies. Materials and methods : A prospective study involving 85 patients with high–risk skin melanoma (according to AJCC criteria) who underwent sentinel lymph node biopsy (BSLU) with preliminary lymphoscintigraphy ( 99m Tc-Nanotop) and extensive excision of the primary tumor. Conclusion : RUCL-M is a step towards precision diagnostics, which retains the importance of BSLU in complex cases. Expands the possibilities of ultrasound for clinical decision-making. Saves resources by reducing overdiagnosis. Implementation requires training of doctors (emphasis on quantitative criteria), adjustment of clinical protocols, and monitoring of long–term outcomes (frequency of relapses or disease progression, especially in patients with high-risk skin melanoma who have not undergone BSLU)