The use of FDG‐PET/CT to detect early recurrence after resection of high‐risk stage III melanoma. Issue 7 (11th August 2020)

• Record Type: Journal Article
• Authors: Stahlie, Emma H. A.; van der Hiel, Bernies; Stokkel, Marcel P. M.; Schrage, Yvonne M.; van Houdt, Winan J.; Wouters, Michel W.; van Akkooi, Alexander C. J.
• Is Part Of: Journal of surgical oncology. Volume 122:Issue 7(2020)
• Page Start: 1328
• Page End: 1336
• Publication Date: 2020-08-11
• Subjects: adjuvant -- asymptomatic -- follow‐up -- imaging -- relapse -- screening -- surveillance; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.26155
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract: Background: The role of surveillance imaging in high‐risk stage III melanoma patients after complete surgical resection remains controversial, and with the advent of adjuvant therapy, it may also be expanded. Therefore, we evaluated two fluorine‐18 fluorodeoxyglucose‐positron emission tomography/computed tomography (FDG‐PET/CT) protocols in two cohorts. Methods: Cohort 1 (n = 35) focused on surveillance in asymptomatic patients (before approval and reimbursement of adjuvant therapy) and was assigned to 5x FDG‐PET/CT's after surgery: one every 6 months for 2 years, with one final scan after 3 years. Cohort 2 (n = 42) was assigned to one screening FDG‐PET/CT, which took place in between surgery and the start of adjuvant treatment. Results: In cohort 1 (median follow‐up: 33 months), 12 patients (34.3%) developed recurrence detected by FDG‐PET/CT, of which 7 (20.0%) were detected with the first scan. Sensitivity and specificity were 92.3% and 100%, respectively. In cohort 2, recurrence was suspected on nine scans (21.4%) and four (9.5%) were true positive. The number of scans needed to find one asymptomatic recurrence were 8.8 and 10.5 in cohort 1 and 2, respectively. Conclusions: FDG‐PET/CT is a valuable imaging tool to detect recurrence in stage III melanoma, even shortly after surgery. A surveillance FDG‐PET/CT protocol after surgery or a screening PET/CT before adjuvant therapy should be considered.