The utility of PET-CT in the staging and management of advanced and recurrent malignant melanoma

Keywords: PET-CT, Melanoma, Staging, surgical selection melanoma

Abstract

Background: Accurate pre-operative staging and correct surgical selection of patients with malignant melanoma reduces unnecessary morbidity and mortality, improves distant control and may improve survival. 18F-fluorodeoxyglucose Positron Emission Tomography Computed Tomography (18F-FDG PET-CT) has been shown to be useful in exclusion of metastatic sites and aids in surgical planning in stage III and potentially resectable stage IV disease. The primary objective of the study was to determine whether the use of PET-CT alters the initial staging and management of patients with advanced and recurrent melanoma.

Methods: Retrospective analysis of clinical records of patients with malignant melanoma referred for staging PET-CT over a three-year period at our institution was performed. Pre- and post-PET-CT stage was recorded and a descriptive analysis was done to determine whether PET-CT resulted in a change in stage grouping and whether this change effected a change in clinical management.

Results: A change in stage grouping occurred in 21/39 (53.8%) of patients, 76.2% of which were up-staged and 23.8% down staged. On analysis of stage III/IV and recurrent melanoma, a change in stage occurred in 90% of stage III, 50% of stage IV and 50% of recurrent melanoma patients. This effected a change in management in 86.7% of patients with stage III, IV and recurrent melanoma collectively.

Conclusion: PET-CT is a useful tool in the staging and subsequent management of melanoma. Its utility is pronounced in advanced and recurrent melanoma.

Author Biographies

S H Twycross, Stellenbosch University

Division of Radiation Oncology, Department of Medical Imaging and Clinical Oncology, Stellenbosch University
and Tygerberg Academic Hospital, Cape Town, South Africa

H Burger, Stellenbosch University

Division of Radiation Oncology, Department of Medical Imaging and Clinical Oncology, Stellenbosch University
and Tygerberg Academic Hospital, Cape Town, South Africa

J Holness, Stellenbosch University

Division of Nuclear Medicine, Department of Medical Imaging and Clinical Oncology, Stellenbosch University
and Tygerberg Academic Hospital, Cape Town, South Africa

Published
2019-05-14
How to Cite
Twycross, S., Burger, H., & Holness, J. (2019). The utility of PET-CT in the staging and management of advanced and recurrent malignant melanoma. South African Journal of Surgery, 57(3), 44-49. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/2832
Section
Oncology