TY - JOUR
T1 - Earlier Recurrence Detection Using Routine FDG PET-CT Scans in Surveillance of Stage IIB to IIID Melanoma
T2 - A National Cohort Study of 1480 Patients
AU - Helvind, Neel Maria
AU - Weitemeyer, Marie Brinch Møller
AU - Chakera, Annette Hougaard
AU - Hendel, Helle Westergren
AU - Ellebæk, Eva
AU - Svane, Inge Marie
AU - Kjærskov, Mette Wanscher
AU - Bojesen, Sophie
AU - Skyum, Helle
AU - Petersen, Søren Kjær
AU - Bastholt, Lars
AU - Johansen, Christoffer
AU - Bidstrup, Pernille Envold
AU - Hölmich, Lisbet Rosenkrantz
N1 - Funding Information:
This study was funded by research grants from The Danish Cancer Society, The Danish Cancer Research Foundation, and the Research Foundation of Copenhagen University Hospital: Herlev and Gentofte.
Publisher Copyright:
© 2023, Society of Surgical Oncology.
PY - 2023
Y1 - 2023
N2 - 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: 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: 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: 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.
AB - 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: 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: 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: 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.
U2 - 10.1245/s10434-022-13034-6
DO - 10.1245/s10434-022-13034-6
M3 - Journal article
C2 - 36752970
AN - SCOPUS:85147653596
VL - 30
SP - 2377
EP - 2388
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 4
ER -