¹⁸FDG-PET to assess recurrence and long term survival in patients with malignant melanoma

Summary

Aim: To assess the diagnostic and prognostic value of FDG-PET/CT in the follow-up of malignant melanoma in comparison to the serum protein S100B. Patients and methods: A total of ninety patients with either low-risk or high-risk malignant melanoma, respectively, were included in this study. The followup of the patients was pursuant with the guidelines of the German Dermatological Association. The diagnostic accuracy and diagnostic power were determined for PET/CT and for the serum protein S100B. Results: In 28 of the 90 patients PET/CT was positive in the follow up, 47 patients had an elevated Serum S100B level. Sensitivity, specificity, PPV and NPV of PET/CT for the total groups of patients were 87%, 93%, 87% and 93%. The corresponding values for the serum protein S100B were 65%, 52%, 43% and 74%, respectively. PET/CT positive patients showed a significantly (p < 0.001) higher risk of melanoma associated death compared to patients with PET/CT negative findings. No statistical significance could be found in the 5 year survival rate between the S100B positive and S100B negative patients. Conclusion: PET/CT is suitable to confirm or exclude recurrences and can be used to assess the prognosis in melanoma patients. The diagnostic accuracy and the prognostic power is much higher compared to the serum protein S100B.

Zusammenfassung

Ziel: Die diagnostische und prognostische Genauigkeit der PET/CT in der Nachsorge des malignen Melanoms zu überprüfen. Patienten, Methoden: Insgesamt wurden 95 Patienten mit low-risk oder high-risk malignem Melanom in die Studie eingeschlossen. Die Nachsorge erfolgte nach den Leitlinien der Deutschen Dermatologischen Gesellschaft. Die diagnostische Genauigkeit wurde für die PET/ CT und das Serumprotein S100B bestimmt. Ergebnisse: In der Nachsorge hatten 28 der 90 Patienten ein positives PET/CT hinsichtlich eines Rezidives, 47 Patienten wiesen ein erhöhtes S100B-Serumprotein auf. Die Sensitivität, Spezifität, PPV und NPV für die PET/CT in der Gesamtgruppe der Patienten war 87%, 93%, 87% und 93%. Die entsprechenden Werte für das Serumprotein S100B waren 65%, 52%, 43% und 74%. PET/CT-positive Patienten zeigten ein signifikant längeres Überleben (p < 0,001) als PET/CT-negative Patienten. Es konnte kein statistisch signifikanter Unterschied hinsichtlich des 5-Jahresüberlebens zwischen S100B-positiven und -negativen Patienten gefunden werden. Schlussfolgerung: Die PET/CT kann zum Nachweis oder zum Ausschluss eines Rezidives und zur Bestimmung der Prognose bei Patienten mit malignem Melanom eingesetzt werden. Die diagnostische Genauigkeit ist der des Serumproteins S100B überlegen.

Keywords

PET/CT - recurrence - survival - malignant melanoma

Schlüsselwörter

PET/CT - Rezidiv - Überleben - malignes Melanom

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