Annals of surgical oncology · 2013
Outcome of clinical stage III melanoma patients with FDG-PET and whole-body CT added to the diagnostic workup.
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Niebling M G, Bastiaannet E, Hoekstra O S, Bonenkamp J J, Koelemij R, Hoekstra H J
Аннотация
BACKGROUND: Combined whole-body FDG-PET and CT provide the most comprehensive staging of melanoma patients with palpable lymph node metastases (LNM). The aim of this study is to analyze survival of FDG-PET and CT negative or positive melanoma patients and to assess which factors have independent prognostic impact on survival of these patients.
METHODS: Patients with palpable and histologically or cytologically proven LNM of melanoma, referred to participating hospitals for examination with FDG-PET and CT, were selected from a previous study. Melanoma-specific survival (MSS) and disease-free period (DFP) were analyzed for FDG-PET and CT positive and negative patients using the Kaplan-Meier method. Cox-regression analysis was performed to analyze which patient or melanoma characteristics had significant impact on MSS or DFP.
RESULTS: For all 252 patients 5-year MSS was 38.2%. For FDG-PET and CT negative and positive patients 5-year MSS was 47.6 and 16.9%, respectively. Disease-free period for FDG-PET and CT negative patients was 46.0% after 5 years. Gender, a positive FDG-PET and CT, LNM in axilla compared to head or neck, and presence of extranodal growth were independent factors for worse MSS in all patients. Positive FDG-PET and CT was the most important prognostic factor for MSS with a hazard ratio of 2.54 (95% CI, 1.55-4.17, P<0.001).
CONCLUSIONS: Staging melanoma patients with palpable LNM is more accurate when whole-body FDG-PET and CT is added to the diagnostic workup. Hence, FDG-PET and CT, preferably combined, are indicated in the staging of clinical stage III melanoma patients.
METHODS: Patients with palpable and histologically or cytologically proven LNM of melanoma, referred to participating hospitals for examination with FDG-PET and CT, were selected from a previous study. Melanoma-specific survival (MSS) and disease-free period (DFP) were analyzed for FDG-PET and CT positive and negative patients using the Kaplan-Meier method. Cox-regression analysis was performed to analyze which patient or melanoma characteristics had significant impact on MSS or DFP.
RESULTS: For all 252 patients 5-year MSS was 38.2%. For FDG-PET and CT negative and positive patients 5-year MSS was 47.6 and 16.9%, respectively. Disease-free period for FDG-PET and CT negative patients was 46.0% after 5 years. Gender, a positive FDG-PET and CT, LNM in axilla compared to head or neck, and presence of extranodal growth were independent factors for worse MSS in all patients. Positive FDG-PET and CT was the most important prognostic factor for MSS with a hazard ratio of 2.54 (95% CI, 1.55-4.17, P<0.001).
CONCLUSIONS: Staging melanoma patients with palpable LNM is more accurate when whole-body FDG-PET and CT is added to the diagnostic workup. Hence, FDG-PET and CT, preferably combined, are indicated in the staging of clinical stage III melanoma patients.
Предметные рубрики MeSH
AdultAgedAged, 80 and overCohort StudiesFemaleFluorodeoxyglucose F18Follow-Up StudiesHumansLymphatic MetastasisMaleMelanomaMiddle AgedMultimodal ImagingNeoplasm StagingPositron-Emission TomographyPrognosisRadiopharmaceuticalsSkin NeoplasmsSurvival RateTomography, X-Ray ComputedYoung AdultCutaneous Malignant Melanoma