常规重新分期 PET/CT 以及在前哨淋巴结阳性 III 期黑色素瘤中检测初始复发。

Routine restaging PET/CT and detection of initial recurrence in sentinel lymph node positive stage III melanoma.

机构信息

Division of Surgical Oncology and Endocrine Surgery and The Lineberger Comprehensive Cancer Center, Department of Surgery, University of North Carolina at Chapel Hill, Campus Box 7213, 170 Manning Drive, 1150 POB, Chapel Hill, NC 27599, USA.

出版信息

Am J Surg. 2014 Apr;207(4):549-54. doi: 10.1016/j.amjsurg.2013.04.012.

DOI:10.1016/j.amjsurg.2013.04.012

PMID:24674829

Abstract

BACKGROUND

Follow-up of patients with sentinel lymph node-positive stage III melanoma uses history, physical exam, and cross-sectional imaging. The aim of this study was to evaluate positron emission tomographic (PET)/computed tomographic (CT) scans in the detection of recurrence.

METHODS

From 2003 to 2009, a single-institution prospective database of all cutaneous melanoma patients was used to identify sentinel lymph node-positive stage III patients with disease-free survival >1 year and 1 restaging PET/CT scan.

RESULTS

Thirty-eight patients were identified, with a median follow-up period of 27.5 months. Seven (18%) developed recurrence (median time to recurrence, 25 months). Recurrences were detected as follows: 3 by patients, 1 by physician, 1 by PET/CT scan and lactate dehydrogenase, 1 by PET/CT scan, and 1 by brain magnetic resonance imaging. One hundred eight follow-up PET/CT scans were performed. Two of 38 patients had asymptomatic metastases detected by routine restaging PET/CT scan, and there were 9 scans with false-positive results.

CONCLUSIONS

With short follow-up, the utility of routine PET/CT scans in identifying unsuspected recurrence in patients with sentinel lymph node-positive stage III melanoma appears minimal.

摘要

背景

前哨淋巴结阳性 III 期黑色素瘤患者的随访采用病史、体格检查和横断面成像。本研究的目的是评估正电子发射断层扫描（PET）/计算机断层扫描（CT）扫描在检测复发方面的作用。

方法

从 2003 年到 2009 年，使用单机构前瞻性数据库来确定前哨淋巴结阳性 III 期且无病生存时间超过 1 年且有 1 次重新分期 PET/CT 扫描的皮肤黑色素瘤患者。

结果

共确定了 38 例患者，中位随访时间为 27.5 个月。7 例（18%）出现复发（中位复发时间为 25 个月）。复发情况如下：3 例由患者发现，1 例由医生发现，1 例由 PET/CT 扫描和乳酸脱氢酶发现，1 例由 PET/CT 扫描发现，1 例由脑磁共振成像发现。进行了 108 次随访 PET/CT 扫描。38 例患者中有 2 例通过常规重新分期 PET/CT 扫描发现无症状转移，有 9 次扫描结果为假阳性。