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Positron Emission Tomography Helpful Diagnosing Patients with Stage III Melanoma: Presented at SSO

By Mike Fillon

ATLANTA, GA -- March 8, 2005 -- Fluorodeoxyglucose positron emission tomography (FDG-PET) may be valuable for diagnosing patients with stage III melanoma to detect distant metastases and to identify candidates for surgery and/or systemic treatment, according to a presentation at the Society of Surgical Oncology 58th Annual Cancer Symposium.

Harald J. Hoekstra, MD, Professor, Department of Surgical Oncology, Groningen University Medical Center, Groningen, The Netherlands, presented evidence of the diagnostic technique's efficacy during a poster session on March 6^th.

The FDG-PET technique detects active malignant lesions, including lung cancer, colorectal cancer, lymphoma, melanoma, breast cancer, ovarian cancer, brain cancer and multiple myeloma. FDG-PET scans may also be used to stage and monitor a patient's response to therapy for malignant disease.

Previously, studies have shown that FDG-PET has adequate sensitivity and specificity for the detection of melanoma metastases. However, few studies have addressed its efficacy in monitoring the impact of treatment.

Dr. Hoekstra and colleagues therefore conducted a retrospective study to determine the value of FDG-PET and the impact on treatment of melanoma patients in three university medical centers in the Netherlands.

They reviewed the medical records of 257 patients, recording the indications for FDG-PET and the findings obtained. Unexpected findings of suspected premalignant tumors other than melanoma were assessed and treatment plans before and after FDG-PET were recorded from reports of patient visits and were analyzed to evaluate any changes in disease management.

Scans were requested for staging in 71% of cases, mainly to detect distant metastases in stage III patients. Overall, 22% of patients were upstaged as a result of the PET scan. Treatment was changed in 17% of patients, usually from surgery to systemic treatment in patients with stage III disease, unexpected, mainly colorectal, tumors were detected in 4% of patients.

In 37% of stage III patients, surgical treatment changed as a result of the PET scan, Dr. Hoekstra said.

Unexpected findings were detected in 4.3% of patients; colon or rectal polyps in 1.9%, colorectal cancer in 1.2%, hypofyse adenoma in 0.4%, and no further diagnostics (colon and intestinal) in 0.8%.

Unexpected FDG-PET findings should not be disregarded, Dr. Hoekstra said, as premalignant clinical relevant tumors may be identified.


[Presentation title: Impact of FDG-PET on Surgical Management of Melanoma. Abstract P178]

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