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Annals of Surgical Oncology
Erschienen in:

03.01.2021 | Melanoma

Performance of Long-Term CT and PET/CT Surveillance for Detection of Distant Recurrence in Patients with Resected Stage IIIA–D Melanoma

verfasst von: Robin M. Turner, PhD, MBiostat, Mbathio Dieng, PhD, MPH, Nikita Khanna, MEcon, Mai Nguyen, MSc, Jiaxu Zeng, PhD, Amanda A. G. Nijhuis, MD, PhD, Omgo E. Nieweg, PhD, MD, Andrew J. Einstein, MD, PhD, Louise Emmett, MD, Sarah J. Lord, MBBS, MSc, Alexander M. Menzies, PhD, MD, John F. Thompson, MD, Robyn P. M. Saw, MD, Rachael L. Morton, PhD, MSc

Erschienen in: Annals of Surgical Oncology | Ausgabe 8/2021

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Abstract

Background

Follow-up for patients with resected stage IIIA–D melanoma may include computed tomography (CT) or positron emission tomography (PET)/CT imaging to identify distant metastases. The aim of this study was to evaluate the test performance over follow-up time, of structured 6- and 12-monthly follow-up imaging schedules in these patients.

Methods

We conducted a retrospective analysis of consecutive resected stage IIIA–D melanoma patients from Melanoma Institute Australia (2000–2017). Patients were followed until a confirmed diagnosis of distant metastasis, end of follow-up schedule, or death. Test accuracy was evaluated by cross-classifying the results of the test against a composite reference standard of histopathology, cytology, radiologic imaging, and/or clinical follow-up, and then quantified longitudinally using logistic regression models with random effects.

Results

In total, 1373 imaging tests were performed among 332 patients. Distant metastases were detected in 110 (33%) patients during a median follow-up of 61 months (interquartile range 38–86), and first detected by imaging in 86 (78%) patients. 152 (68%) patients had at least one false-positive result. Sensitivity of the schedule over 5 years was 79% [95% confidence interval (CI) 70–86%] and specificity was 88% (95% CI 86–90%). There was no evidence of a significant difference in test performance over follow-up time or by American Joint Committee on Cancer (AJCC) substage. The positive predictive value ranged between 33 and 48% over follow-up time, reflecting a ratio of 1:2 false-positives per true-positive finding.

Conclusions

Regular 6- or 12-monthly surveillance imaging using CT or PET/CT has reasonable and consistent sensitivity and specificity over 5-year follow-up for resected stage IIIA–D melanoma patients. These data are useful when discussing the risks and benefits of long-term follow-up.
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Metadaten
Titel
Performance of Long-Term CT and PET/CT Surveillance for Detection of Distant Recurrence in Patients with Resected Stage IIIA–D Melanoma
verfasst von
Robin M. Turner, PhD, MBiostat
Mbathio Dieng, PhD, MPH
Nikita Khanna, MEcon
Mai Nguyen, MSc
Jiaxu Zeng, PhD
Amanda A. G. Nijhuis, MD, PhD
Omgo E. Nieweg, PhD, MD
Andrew J. Einstein, MD, PhD
Louise Emmett, MD
Sarah J. Lord, MBBS, MSc
Alexander M. Menzies, PhD, MD
John F. Thompson, MD
Robyn P. M. Saw, MD
Rachael L. Morton, PhD, MSc
Publikationsdatum
03.01.2021
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 8/2021
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-09270-3

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