Clinical and prognostic value of FDG PET/CT in malignant melanoma after surgery

Objectives: Malignant melanoma is a highly aggressive tumor, surgical resection being the primary treatment. However despite complete resection chances of recurrence within 2-3 years are quite high. Aim of this retrospective study was to evaluate the utility of FDG PET-CT in recurrence/restaging of...

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Bibliographic Details
Published inThe Journal of nuclear medicine (1978) Vol. 58; p. 15
Main Authors Malik, Dharmender, Kumar, Rajender, Jain, Tarun, Bhattacharya, Anish, Mittal, Bhagwant
Format Journal Article
LanguageEnglish
Published New York Society of Nuclear Medicine 01.05.2017
Subjects
Computed tomography
Diagnostic systems
Health risks
Malignancy
Medical prognosis
Medical treatment
Melanoma
Metastases
Patients
Positron emission
Positron emission tomography
Regression analysis
Risk assessment
Surgery
Survival
Tomography
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Summary:Objectives: Malignant melanoma is a highly aggressive tumor, surgical resection being the primary treatment. However despite complete resection chances of recurrence within 2-3 years are quite high. Aim of this retrospective study was to evaluate the utility of FDG PET-CT in recurrence/restaging of malignant melanoma after surgery and its prognostic implication. Methods: Fifty-four (Female 32, Male 22) surgically treated patients, who underwent FDG-PET for suspicious of recurrent/residual disease were evaluated. The diagnostic accuracy of visually interpreted FDG-PET was obtained by considering treatment received (n=33) and clinical follow-up (n=54 pts). Overall survival (OS) was assessed by using Kaplan-Meier method. The risk of progression (Hazard Ratio-HR) was computed by Cox regression analysis. Results: A positive FDG PET-CT for residual/recurrent diseases was observed in thirty-two patients. Also FDG PET-CT revealed distant metastasis in 12 patients and second synchronous malignancy in two patients. Overall, the sensitivity, specificity, positive predictive value and negative predictive value of FDG-PET were 91.2%, 80.0%, 88.6%, 84.2%. AUC was 0.86 (95%IC 0.74-0.97; p<0.05). After follow-up of 21.9±18.4 months, a negative FDG PET-CT study was associated with a significantly longer overall survival than a positive one (64.5±6.9 vs 30.8±4.6 months, p<0.05). In addition, a positive PET scan was associated with an increased risk of disease progression (HR=7.72; p<0.05). Conclusion: FDG-PET/CT showed a valuable diagnostic performance in patients with suspicious of residual/recurrent malignant melanoma leading to change in management protocol. FDG PET-CT provides important prognostic value in predicting the survival outcomes and assessing the risk of disease progression.
ISSN:0161-5505
1535-5667