Zachary J Jaeger1, Gregory A Williams2,3, Ling Chen4, Joyce C Mhlanga5, Lynn A Cornelius3,6, Ryan C Fields2,3. 1. Office of Medical Student Education, Washington University School of Medicine, St. Louis, Missouri, USA. 2. Section of Surgical Oncology, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA. 3. Alvin J. Siteman Comprehensive Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA. 4. Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA. 5. Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA. 6. Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
Abstract
BACKGROUND AND OBJECTIVES: High recurrence rates of Stages II and IIIA melanoma make close follow-up essential, especially with new adjuvant therapies for metastatic disease. However, there are currently no consensus guidelines for routine imaging for Stages IIB, IIC, and IIIA melanoma. The study's aim is to determine the utility of 18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting asymptomatic recurrence of melanoma after primary surgical resection. METHODS: This retrospective cohort study included 158 patients with the American Joint Committee on Cancer 8th edition Stages IIB, IIC, or IIIA cutaneous melanoma who underwent an 18 F-FDG PET/CT from 2010 to 2020. We retrospectively analyzed clinical data after a median follow-up time of 39 months. RESULTS: We calculated a positive predictive value (PPV) of 32% (95% confidence interval: 11%-53%) for 154 routine PET/CTs, including six true positives and 13 false positives (FPs). PPV was 33% for Stage IIB, 50% for Stage IIC, and 14% for Stage IIIA. FPs were mostly benign or inflammatory foci (75%), and some other malignancies were found (21%). CONCLUSIONS: This cohort of patients imaged for high-risk melanoma demonstrated a high FP rate and low PPV. These findings suggest that routine surveillance with 18 F-FDG PET/CT may not be indicated for monitoring recurrence in this population.
BACKGROUND AND OBJECTIVES: High recurrence rates of Stages II and IIIA melanoma make close follow-up essential, especially with new adjuvant therapies for metastatic disease. However, there are currently no consensus guidelines for routine imaging for Stages IIB, IIC, and IIIA melanoma. The study's aim is to determine the utility of 18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) for detecting asymptomatic recurrence of melanoma after primary surgical resection. METHODS: This retrospective cohort study included 158 patients with the American Joint Committee on Cancer 8th edition Stages IIB, IIC, or IIIA cutaneous melanoma who underwent an 18 F-FDG PET/CT from 2010 to 2020. We retrospectively analyzed clinical data after a median follow-up time of 39 months. RESULTS: We calculated a positive predictive value (PPV) of 32% (95% confidence interval: 11%-53%) for 154 routine PET/CTs, including six true positives and 13 false positives (FPs). PPV was 33% for Stage IIB, 50% for Stage IIC, and 14% for Stage IIIA. FPs were mostly benign or inflammatory foci (75%), and some other malignancies were found (21%). CONCLUSIONS: This cohort of patients imaged for high-risk melanoma demonstrated a high FP rate and low PPV. These findings suggest that routine surveillance with 18 F-FDG PET/CT may not be indicated for monitoring recurrence in this population.
Authors: Mark B Faries; John F Thompson; Alistair J Cochran; Robert H Andtbacka; Nicola Mozzillo; Jonathan S Zager; Tiina Jahkola; Tawnya L Bowles; Alessandro Testori; Peter D Beitsch; Harald J Hoekstra; Marc Moncrieff; Christian Ingvar; Michel W J M Wouters; Michael S Sabel; Edward A Levine; Doreen Agnese; Michael Henderson; Reinhard Dummer; Carlo R Rossi; Rogerio I Neves; Steven D Trocha; Frances Wright; David R Byrd; Maurice Matter; Eddy Hsueh; Alastair MacKenzie-Ross; Douglas B Johnson; Patrick Terheyden; Adam C Berger; Tara L Huston; Jeffrey D Wayne; B Mark Smithers; Heather B Neuman; Schlomo Schneebaum; Jeffrey E Gershenwald; Charlotte E Ariyan; Darius C Desai; Lisa Jacobs; Kelly M McMasters; Anja Gesierich; Peter Hersey; Steven D Bines; John M Kane; Richard J Barth; Gregory McKinnon; Jeffrey M Farma; Erwin Schultz; Sergi Vidal-Sicart; Richard A Hoefer; James M Lewis; Randall Scheri; Mark C Kelley; Omgo E Nieweg; R Dirk Noyes; Dave S B Hoon; He-Jing Wang; David A Elashoff; Robert M Elashoff Journal: N Engl J Med Date: 2017-06-08 Impact factor: 91.245
Authors: F Stephen Hodi; Steven J O'Day; David F McDermott; Robert W Weber; Jeffrey A Sosman; John B Haanen; Rene Gonzalez; Caroline Robert; Dirk Schadendorf; Jessica C Hassel; Wallace Akerley; Alfons J M van den Eertwegh; Jose Lutzky; Paul Lorigan; Julia M Vaubel; Gerald P Linette; David Hogg; Christian H Ottensmeier; Celeste Lebbé; Christian Peschel; Ian Quirt; Joseph I Clark; Jedd D Wolchok; Jeffrey S Weber; Jason Tian; Michael J Yellin; Geoffrey M Nichol; Axel Hoos; Walter J Urba Journal: N Engl J Med Date: 2010-06-05 Impact factor: 91.245
Authors: Andrea Marie Ibrahim; Melanie Le May; Dominick Bossé; Horia Marginean; Xinni Song; Carolyn Nessim; Michael Ong Journal: Ann Surg Oncol Date: 2020-05-03 Impact factor: 5.344
Authors: Alexander M M Eggermont; Christian U Blank; Mario Mandala; Georgina V Long; Victoria G Atkinson; Stéphane Dalle; Andrew M Haydon; Andrey Meshcheryakov; Adnan Khattak; Matteo S Carlino; Shahneen Sandhu; James Larkin; Susana Puig; Paolo A Ascierto; Piotr Rutkowski; Dirk Schadendorf; Rutger Koornstra; Leonel Hernandez-Aya; Anna Maria Di Giacomo; Alfonsus J M van den Eertwegh; Jean-Jacques Grob; Ralf Gutzmer; Rahima Jamal; Paul C Lorigan; Alexander C J van Akkooi; Clemens Krepler; Nageatte Ibrahim; Sandrine Marreaud; Michal Kicinski; Stefan Suciu; Caroline Robert Journal: J Clin Oncol Date: 2020-09-18 Impact factor: 44.544