Hlongwa Khanyisile N, Mokoala Kgomotso M G, Matsena-Zingoni Zvifadzo, Vorster Mariza, Sathekge Mike M
Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria 0001, South Africa.
Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg 2193, South Africa.
Diagnostics (Basel). 2022 Feb 25;12(3):595. doi: 10.3390/diagnostics12030595.
Malignant melanoma is one of the more aggressive cancers in the skin, with an increasing incidence every year. Melanoma has a better prognosis if diagnosed early and survival tends to decrease once the disease has metastasized. Positron emission tomography (PET) with 2-[F]fluoro-2-deoxy-D-glucose (F-FDG) has been used extensively over the past two decades in staging and assessing responses to therapy in patients with melanoma. Metabolic PET parameters have been demonstrated to be independent prognostic factors for progression-free survival (PFS) and overall survival (OS) in different malignancies, melanoma included. In our study, we evaluated the metabolic parameters of F-FDG PET/CT (flourodeoxyglucose positron emission tomography/computed tomography) in predicting the overall survival in patients with malignant melanoma who presented for restaging. Metabolic PET parameters (maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG)) of the primary tumor, as well as whole-body MTV and TLG of the metastatic disease, were measured. Survival curves for OS were constructed and mortality rates were determined using the different PET variables. Forty-nine patients who presented for a PET/CT restaging in melanoma were included in this study. We found that non-survivors had significantly higher median MTV (11.86 cm vs. 5.68 cm; -value = 0.022), TLG (3125 vs. 14; -value = 0.0357), whole-body MTV (53.9 cm vs. 14.4 cm; -value = 0.0076) and whole-body TLG (963.4 vs. 114.6; -value = 0.0056). This demonstrated that high MTV and TLG values of the primary tumor and whole-body TLG as quantified by F-FDG PET/CT were prognostic factors for overall survival. The findings may potentially guide clinicians in decision making and identifying patients with a poorer prognosis.
恶性黑色素瘤是皮肤中侵袭性较强的癌症之一，其发病率逐年上升。如果早期诊断，黑色素瘤的预后较好，一旦疾病发生转移，生存率往往会下降。在过去二十年中，2-[F]氟-2-脱氧-D-葡萄糖（F-FDG）正电子发射断层扫描（PET）已广泛用于黑色素瘤患者的分期和评估治疗反应。代谢PET参数已被证明是不同恶性肿瘤（包括黑色素瘤）无进展生存期（PFS）和总生存期（OS）的独立预后因素。在我们的研究中，我们评估了F-FDG PET/CT（氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描）的代谢参数，以预测进行再分期的恶性黑色素瘤患者的总生存期。测量了原发性肿瘤的代谢PET参数（最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病灶糖酵解（TLG）），以及转移性疾病的全身MTV和TLG。构建了OS的生存曲线，并使用不同的PET变量确定死亡率。本研究纳入了49例进行黑色素瘤PET/CT再分期的患者。我们发现，非幸存者的中位MTV（11.86 cm对5.68 cm；P值 = 0.022）、TLG（3125对14；P值 = 0.0357）、全身MTV（53.9 cm对14.4 cm；P值 = 0.0076）和全身TLG（963.4对114.6；P值 = 0.0056）显著更高。这表明，F-FDG PET/CT定量的原发性肿瘤的高MTV和TLG值以及全身TLG是总生存期的预后因素。这些发现可能会潜在地指导临床医生进行决策并识别预后较差的患者。
