OBJECTIVE/ BACKGROUND: There is a high risk of relapse in stage IIIB/IIIC melanoma. The utility of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography integrated with computed tomography (FDG-PET/CT) in these patients to evaluate response to treatment or for surveillance after treatment is currently not well defined. METHODS: Prospective data from 2 centers identified 97 patients with stage IIIB/IIIC extremity melanoma undergoing isolated limb infusion (ILI) who had whole body FDG-PET/CT scans before and every 3 months after treatment. Clinical response was determined at 3 months by Response Evaluation Criteria In Solid Tumors. RESULTS: Complete response (CR) after ILI occurred in 33% (32/97) of patients. FDG-PET/CT accurately identified 59% of patients who were CRs (19/32), whereas 41% (13/32) had residual metabolic activity in the extremity that was histologically negative for melanoma. The 3-year disease-free rate was 62.2% (95% CI: 40.1%-96.4%) for those patients who were CRs by both clinical/pathologic examination and FDG-PET/CT (n = 19) compared to only 29.4% (95% CI: 9.9%-87.2%) of those CRs who still had residual FDG-PET/CT activity (n = 13). FDG-PET/CT was utilized for surveillance of disease recurrence outside the regional field of treatment. Fifty-two percent (51/97) of patients developed disease outside the extremity at a median time of 212 days from pre-ILI FDG-PET/CT. In 47% (29/62) of these cases, the recurrence was resected. CONCLUSIONS: Although FDG-PET/CT does not appear to accurately identify patients who appear to be CRs to ILI, it does appear to identify a subgroup of patients whose regional progression-free survival is markedly worse. However, FDG-PET/CT appears to be an excellent method for surveillance in stage IIIB/IIIC patients after ILI with ability to identify surgically resectable recurrent disease in these high-risk patients.
OBJECTIVE/ BACKGROUND: There is a high risk of relapse in stage IIIB/IIIC melanoma. The utility of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography integrated with computed tomography (FDG-PET/CT) in these patients to evaluate response to treatment or for surveillance after treatment is currently not well defined. METHODS: Prospective data from 2 centers identified 97 patients with stage IIIB/IIIC extremity melanoma undergoing isolated limb infusion (ILI) who had whole body FDG-PET/CT scans before and every 3 months after treatment. Clinical response was determined at 3 months by Response Evaluation Criteria In Solid Tumors. RESULTS: Complete response (CR) after ILI occurred in 33% (32/97) of patients. FDG-PET/CT accurately identified 59% of patients who were CRs (19/32), whereas 41% (13/32) had residual metabolic activity in the extremity that was histologically negative for melanoma. The 3-year disease-free rate was 62.2% (95% CI: 40.1%-96.4%) for those patients who were CRs by both clinical/pathologic examination and FDG-PET/CT (n = 19) compared to only 29.4% (95% CI: 9.9%-87.2%) of those CRs who still had residual FDG-PET/CT activity (n = 13). FDG-PET/CT was utilized for surveillance of disease recurrence outside the regional field of treatment. Fifty-two percent (51/97) of patients developed disease outside the extremity at a median time of 212 days from pre-ILI FDG-PET/CT. In 47% (29/62) of these cases, the recurrence was resected. CONCLUSIONS: Although FDG-PET/CT does not appear to accurately identify patients who appear to be CRs to ILI, it does appear to identify a subgroup of patients whose regional progression-free survival is markedly worse. However, FDG-PET/CT appears to be an excellent method for surveillance in stage IIIB/IIIC patients after ILI with ability to identify surgically resectable recurrent disease in these high-risk patients.
Authors: H S Koops; M Vaglini; S Suciu; B B Kroon; J F Thompson; J Göhl; A M Eggermont; F Di Filippo; E T Krementz; D Ruiter; F J Lejeune Journal: J Clin Oncol Date: 1998-09 Impact factor: 44.544
Authors: Steven E Finkelstein; Jorge A Carrasquillo; John M Hoffman; Barbara Galen; Peter Choyke; Donald E White; Steven A Rosenberg; Richard M Sherry Journal: Ann Surg Oncol Date: 2004-07-12 Impact factor: 5.344
Authors: Gerald Antoch; Florian M Vogt; Lutz S Freudenberg; Fridun Nazaradeh; Susanne C Goehde; Jörg Barkhausen; Gerlinde Dahmen; Andreas Bockisch; Jörg F Debatin; Stefan G Ruehm Journal: JAMA Date: 2003-12-24 Impact factor: 56.272
Authors: Diego J Muilenburg; Georgia M Beasley; Zachary J Thompson; Ji-Hyun Lee; Douglas S Tyler; Jonathan S Zager Journal: Ann Surg Oncol Date: 2014-09-06 Impact factor: 5.344
Authors: Jacqueline Dinnes; Lavinia Ferrante di Ruffano; Yemisi Takwoingi; Seau Tak Cheung; Paul Nathan; Rubeta N Matin; Naomi Chuchu; Sue Ann Chan; Alana Durack; Susan E Bayliss; Abha Gulati; Lopa Patel; Clare Davenport; Kathie Godfrey; Manil Subesinghe; Zoe Traill; Jonathan J Deeks; Hywel C Williams Journal: Cochrane Database Syst Rev Date: 2019-07-01