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The Utility of PET-CT in the Staging and Management of Advanced and Recurrent Malignant Melanoma

PET/CT Updates, Research & Education
May 2020

Purpose

Accurate pre-operative staging and correct surgical selection of patients with malignant melanoma reduces unnecessary morbidity and mortality, improves distant control and may improve survival. 18F-fluorodeoxyglucose Positron Emission Tomography Computed Tomography (18F-FDG PET-CT) has been shown to be useful in exclusion of metastatic sites and aids in surgical planning in stage III and potentially resectable stage IV disease. The primary objective of the study was to determine whether the use of PET-CT alters the initial staging and management of patients with advanced and recurrent melanoma.

Methods

Retrospective analysis of clinical records of patients with malignant melanoma referred for staging PET-CT over a three-year period at our institution was performed. Pre- and post-PET-CT stage was recorded and a descriptive analysis was done to determine whether PET-CT resulted in a change in stage grouping and whether this change effected a change in clinical management.

Results

A change in stage grouping occurred in 21/39 (53.8%) of patients, 76.2% of which were up-staged and 23.8% down staged. On analysis of stage III/IV and recurrent melanoma, a change in stage occurred in 90% of stage III, 50% of stage IV and 50% of recurrent melanoma patients. This effected a change in management in 86.7% of patients with stage III, IV and recurrent melanoma collectively.

Conclusion

PET-CT is a useful tool in the staging and subsequent management of melanoma. Its utility is pronounced in advanced and recurrent melanoma.

Source: S Afr J Surg 2019 Sep;57(3):44-49. S H Twycross, H Burger, J Holness.
Retrieved 15 May 2020. < https://pubmed.ncbi.nlm.nih.gov/31392864/

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May Melanoma Awareness Month

The American Cancer Society estimates there will be approximately 100,350 new melanomas diagnosed in the United States in 2020.


The Skin Cancer Foundation offers the following prevention recommendations to help limit your risk:

  • Seek the shade, especially between 10am and 4pm
  • Don’t get sunburned
  • Avoid tanning, and never use UV tanning beds
  • Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses
  • Use a broad-spectrum (UVA/UVB) sunscreen
  • Examine your skin head-to-toe every month
  • See a dermatologist at least once a year for a professional skin exam

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