Routine PET-CT scans provide early and accurate recurrence detection in asymptomatic stage IIB-III melanoma patients
| Autor: | Pernille Envold Bidstrup, Jens Ahm Sørensen, Catalina Aurora Aros Mardones, Annette H. Chakera, Neel Maria Helvind, Lisbet Rosenkrantz Hölmich, Helle W. Hendel |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Denmark Population Routine imaging Asymptomatic Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Positron Emission Tomography Computed Tomography Medicine Stage iib Humans 030212 general & internal medicine Stage (cooking) education Melanoma Aged Neoplasm Staging Retrospective Studies education.field_of_study PET-CT Surveillance business.industry 18F-FDG PET-CT Asymptomatic recurrence General Medicine Middle Aged medicine.disease University hospital Predictive value Oncology 030220 oncology & carcinogenesis Lymph Node Excision Surgery Female Radiology medicine.symptom Neoplasm Recurrence Local business |
| Zdroj: | Helvind, N M, Aros Mardones, C A, Hölmich, L R, Hendel, H W, Bidstrup, P E, Sørensen, J A & Chakera, A H 2021, ' Routine PET-CT scans provide early and accurate recurrence detection in asymptomatic stage IIB-III melanoma patients ', European Journal of Surgical Oncology, vol. 47, no. 12, pp. 3020-3027 . https://doi.org/10.1016/j.ejso.2021.06.011 |
| ISSN: | 1532-2157 |
| Popis: | Introduction The use of routine imaging with 18F-FDG PET-CT (PET-CT) in melanoma surveillance is debated and evidence of its diagnostic value and yield in asymptomatic patients is limited. Denmark introduced nationwide routine surveillance with PET-CT in high-risk patients in 2016. The aim of this study was to examine the sensitivity, specificity, negative and positive predictive values, numbers-needed-to-scan and clinical impact of routine PET-CT in the surveillance of asymptomatic stage IIB-III melanoma patients. Materials and methods Data was retrieved from the population-based Danish Melanoma Database and patient records. All patients diagnosed with stage IIB-III melanoma at two University Hospitals in 2016 and 2017 were included. Patients underwent surveillance with clinical examinations and PET-CT scans at 6, 12, 24 and 36 months. Results In 138 patients, 243 routine PET-CTs were performed within a median follow-up time of 17.7 months. Routine PET-CT detected recurrence at least once in 25 patients (18.1%), including distant recurrence in 19 patients (13.8%). Stage IIB patients had the lowest recurrence rate (11.1%). Numbers-needed-to-scan to detect one distant recurrence was 12.8 patients and median time-to-recurrence was 6.8 months. Sensitivity was 100%, specificity was 94.7% and negative and positive predictive values were 100% and 74.4%, respectively. False positive findings prompted 22 additional investigations (of which ten invasive) in 17 patients (12.3%). Conclusion Routine PET-CT has a high sensitivity and specificity when used in high-risk melanoma surveillance. Time-to-recurrence and stage-specific recurrence rates indicate high gain of early routine imaging at six months especially for stage IIC and III patients. |
| Databáze: | OpenAIRE |
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