Earlier Recurrence Detection Using Routine FDG PET-CT Scans in Surveillance of Stage IIB to IIID Melanoma: A National Cohort Study of 1480 Patients.


Journal

Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840

Informations de publication

Date de publication:
Apr 2023
Historique:
received: 31 08 2022
accepted: 12 12 2022
pubmed: 9 2 2023
medline: 23 3 2023
entrez: 8 2 2023
Statut: ppublish

Résumé

The effect of routine imaging in melanoma surveillance is unknown. In 2016, Denmark was the first country in the world to implement routine imaging with positron emission tomography-computed tomography with fluorodeoxyglucose (FDG PET-CT) in a nationwide, population-based surveillance program. This study aimed to determine the impact of surveillance with routine FDG PET-CT on hazard, cumulative incidence, and absolute risk of overall, locoregional, and distant recurrence detection in patients with stage IIB to IIID cutaneous melanoma. This retrospective, population-based, nationwide cohort study used prospectively collected data from five national health registries to compare hazard, cumulative incidence, and absolute risk of recurrence in patients with cutaneous melanoma diagnosed in 2008-2010 (cohort 1, followed with clinical examinations) and patients with cutaneous melanoma diagnosed in 2016-2017 (cohort 2, followed with clinical examinations and routine FDG PET-CT at 6, 12, 24, and 36 months). The study included 1480 patients with stage IIB to IIID cutaneous melanoma. Cumulative incidences of overall and distant recurrence were higher in cohort 2, with a peak difference at three years (32.3 % vs 27.5 % and 25.8 % vs. 18.5 %, respectively). The hazard of recurrence was higher in cohort 2 during the first two years, with hazard rates for overall and distant recurrence of 1.16 (95 % confidence interval [CI], 0.93-1.44) and 1.51 (95 % CI, 1.16-1.96), respectively. The patterns persisted in absolute risk estimates. Patients with stage IIB to IIID melanoma followed with routine FDG PET-CT had a 51 % increased hazard of distant recurrence detection within the first two years of surveillance. Future studies must determine whether this earlier recurrence detection translates into improved survival.

Sections du résumé

BACKGROUND BACKGROUND
The effect of routine imaging in melanoma surveillance is unknown. In 2016, Denmark was the first country in the world to implement routine imaging with positron emission tomography-computed tomography with fluorodeoxyglucose (FDG PET-CT) in a nationwide, population-based surveillance program. This study aimed to determine the impact of surveillance with routine FDG PET-CT on hazard, cumulative incidence, and absolute risk of overall, locoregional, and distant recurrence detection in patients with stage IIB to IIID cutaneous melanoma.
METHODS METHODS
This retrospective, population-based, nationwide cohort study used prospectively collected data from five national health registries to compare hazard, cumulative incidence, and absolute risk of recurrence in patients with cutaneous melanoma diagnosed in 2008-2010 (cohort 1, followed with clinical examinations) and patients with cutaneous melanoma diagnosed in 2016-2017 (cohort 2, followed with clinical examinations and routine FDG PET-CT at 6, 12, 24, and 36 months).
RESULTS RESULTS
The study included 1480 patients with stage IIB to IIID cutaneous melanoma. Cumulative incidences of overall and distant recurrence were higher in cohort 2, with a peak difference at three years (32.3 % vs 27.5 % and 25.8 % vs. 18.5 %, respectively). The hazard of recurrence was higher in cohort 2 during the first two years, with hazard rates for overall and distant recurrence of 1.16 (95 % confidence interval [CI], 0.93-1.44) and 1.51 (95 % CI, 1.16-1.96), respectively. The patterns persisted in absolute risk estimates.
CONCLUSIONS CONCLUSIONS
Patients with stage IIB to IIID melanoma followed with routine FDG PET-CT had a 51 % increased hazard of distant recurrence detection within the first two years of surveillance. Future studies must determine whether this earlier recurrence detection translates into improved survival.

Identifiants

pubmed: 36752970
doi: 10.1245/s10434-022-13034-6
pii: 10.1245/s10434-022-13034-6
doi:

Substances chimiques

Fluorodeoxyglucose F18 0Z5B2CJX4D
Radiopharmaceuticals 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2377-2388

Subventions

Organisme : Kræftens Bekæmpelse
ID : R175-A11366

Informations de copyright

© 2023. Society of Surgical Oncology.

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Auteurs

Neel Maria Helvind (NM)

Department of Plastic Surgery, Copenhagen University Hospital: Herlev and Gentofte, Herlev, Denmark. neel.maria.helvind@regionh.dk.

Marie Brinch-Møller Weitemeyer (MB)

Department of Plastic Surgery, Copenhagen University Hospital: Herlev and Gentofte, Herlev, Denmark.

Annette Hougaard Chakera (AH)

Department of Plastic Surgery, Copenhagen University Hospital: Herlev and Gentofte, Herlev, Denmark.

Helle Westergren Hendel (HW)

Department of Nuclear Medicine, Copenhagen University Hospital: Herlev and Gentofte, Herlev, Denmark.

Eva Ellebæk (E)

Department of Oncology, Copenhagen University Hospital: Herlev and Gentofte, Herlev, Denmark.

Inge Marie Svane (IM)

Department of Oncology, Copenhagen University Hospital: Herlev and Gentofte, Herlev, Denmark.

Mette Wanscher Kjærskov (MW)

Department of General and Plastic Surgery, Vejle Hospital, Vejle, Denmark.

Sophie Bojesen (S)

Department of Plastic Surgery, Zealand University Hospital, Roskilde, Denmark.

Helle Skyum (H)

Department of Plastic Surgery, Aalborg University Hospital, Aalborg, Denmark.

Søren Kjær Petersen (SK)

Department of Oncology, Odense University Hospital, Odense, Denmark.

Lars Bastholt (L)

Department of Oncology, Odense University Hospital, Odense, Denmark.

Christoffer Johansen (C)

CASTLE-Cancer Late Effect Research, Center for Surgery and Cancer, Oncology Clinic, Rigshospitalet, Copenhagen, Denmark.

Pernille Envold Bidstrup (PE)

Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark.

Lisbet Rosenkrantz Hölmich (LR)

Department of Plastic Surgery, Copenhagen University Hospital: Herlev and Gentofte, Herlev, Denmark.

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