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

  • Melanoma
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

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.

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Race/Ethnicity Data

Because Danish registries do not register race and ethnicity, we were unable to include this information in the patient characteristics presented in Table 1.

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Acknowledgment

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.

Author information

Authors and Affiliations

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

    Neel Maria Helvind MD, PhD, Marie Brinch-Møller Weitemeyer MD, Annette Hougaard Chakera MD, PhD & Lisbet Rosenkrantz Hölmich MD, DMSc

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

    Helle Westergren Hendel MD, PhD

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

    Eva Ellebæk MD, PhD & Inge Marie Svane MD, PhD

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

    Mette Wanscher Kjærskov MD

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

    Sophie Bojesen MD

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

    Helle Skyum MD

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

    Søren Kjær Petersen MD & Lars Bastholt MD

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

    Christoffer Johansen MD, DMSc

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

    Pernille Envold Bidstrup MPsy, PhD

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  1. Neel Maria Helvind MD, PhD
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Correspondence to Neel Maria Helvind MD, PhD.

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Helvind, N.M., Weitemeyer, M.BM., Chakera, A.H. et al. Earlier Recurrence Detection Using Routine FDG PET-CT Scans in Surveillance of Stage IIB to IIID Melanoma: A National Cohort Study of 1480 Patients. Ann Surg Oncol 30, 2377–2388 (2023). https://doi.org/10.1245/s10434-022-13034-6

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