Preoperative FDG-PETCT Is an Important Tool in the Management of Patients with Thick (T4)‎ Melanoma

Abstract EN

The yield of preoperative PET/CT (PET/CT) for regional and distant metastases for thin/intermediate thickness melanoma is low.

Objective of this study is to determine if PET/CT performed for T4 melanomas helps guide management and alter treatment plans.

Methods.

Retrospective cohort of 216 patients with T4 melanomas treated at two tertiary institutions.

Fifty-six patients met our inclusion criteria (T4 lesion, PET/CT and no clinical evidence of metastatic disease).

Results.

Fifty-six patients (M: 32, F: 24) with median tumor thickness of 6 mm were identified.

PET/CT recognized twelve with regional and four patients with metastatic disease.

Melanoma-related treatment plan was altered in 11% of the cases based on PET/CT findings.

PET/CT was negative 60% of the time, in 35% of the cases; it identified incidental findings that required further evaluation.

Conclusion.

Patients with T4 lesions, PET/CT changed the treatment plan 18% of the time.

Regional findings changed the surgical treatment plan in 11% and the adjuvant plan in 7% of our cases due to the finding of metastatic disease.

Additionally 20 patients had incidental findings that required further workup.

In this subset of patients, we feel there is a benefit to PET/CT, and further studies should be performed to validate our findings.