The role of 18 F-FDG PET/CT in the management of Merkel cell carcinoma: The experience of 51 studies in our institution.

Autor: López Prior V; Servicio de Medicina Nuclear, Fundación Instituto Valenciano de Oncología, Valencia, España. Electronic address: loprive@hotmail.com., Llombart Cussac B; Servicio de Dermatología, Fundación Instituto Valenciano de Oncología, Valencia, España.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de medicina nuclear e imagen molecular [Rev Esp Med Nucl Imagen Mol (Engl Ed)] 2021 May-Jun; Vol. 40 (3), pp. 139-148. Date of Electronic Publication: 2021 Jan 13.
DOI: 10.1016/j.remn.2020.11.012
Abstrakt: Objectives: Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor with limited evidence on the role of 18 F-FDG PET/CT. The aim of this study was to assess the impact of the 18 F-FDG PET/CT in the management of MCC.
Methods: Fifty-one studies of 18 F-FDG PET/CT of 35 patients (19 men [54.30%]; 72.17±14.63years) with histologic diagnosis of MCC were retrospectively evaluated. The change in tumor staging and the impact on the treatment were analysed.
Results: There were 23 PET/CT positive studies (45.10%) and 28 (54.90%) negative. Thirty four (66.7%) studies were performed for assessment of stage at initial presentation and 17 (33.3%) were performed during the follow up: 6 (35.29%) for suspected recurrence; 7 (41.18%) for restaging; 4 (23.53%) as a part of ongoing surveillance. On the basis of PET/CT results, there was a change in disease stage (SC) in 20 studies (39.20%) and impact in the management (MI) in 28 (54.90%): 11 (32.40%) SC and 12 (35.30%) MI in the initial staging; 5 (71.43%) SC and 7 (100%) MI in the restaging; 3 (50.00%) SC and 6 (100%) MI in suspected recurrence; 1 (25.00%) SC and 3 (75.00%) MI in the surveillance. 18 F-FDG PET/CT incidentally detected one additional histologically confirmed cancer. The presence of nodal involvement in the beginning (0.0098; HR 3.82; 95%CI: 1.38-10.6), chemotherapy treatment (6e-04; HR 7.06; 95%CI: 2.30-21.60), size of primary tumor >2cm (6e-04; HR 7.06; 95%CI: 2.30-21.60) and positive resection margin (0.00069; HR 4.01; 95%CI: 1.46-11.00) were statistically significant prognostic factors for overall survival. There was a trend towards significance for worse overall survival with initial positive 18 F-FDG PET/CT but the trend did not reach statistical significance.
Conclusion: 18 F-FDG PET/CT altered the stage in 2 out of 5 studies and changed the treatment in more than half of the studies performed. The study confirms the important impact of 18 F-FDG PET/CT on the management of MCC patients.
(Copyright © 2020 Sociedad Española de Medicina Nuclear e Imagen Molecular. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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