Routine Computer Tomography Imaging for the Detection of Recurrences in High-Risk Melanoma Patients.

Abstract:

BACKGROUND:The use of routine CT imaging for surveillance in asymptomatic patients with cutaneous melanoma is controversial. We report our experience using a surveillance strategy that included CT imaging for a cohort of patients with high-risk melanoma. METHODS:A total of 466 patients with high-risk cutaneous melanoma enrolled in adjuvant immunotherapy trials were followed for tumor progression by physical examination, labs, and CT imaging as defined by protocol. Evaluations were obtained at least every 6 months for year 1, every 6 months for year 2, and then annually for the remainder of the 5-year study. Time to tumor progression, sites of recurrence, and the method of relapse detection were identified. RESULTS:The patient cohort consisted of 115 stage II patients, 328 stage III patients, and 23 patients with resected stage IV melanoma. The medium time to progression for the 225 patients who developed tumor progression was 7 months. Tumor progression was detected by patients, physician examination or routine labs, or by CT imaging alone in 27, 14, and 59% of cases respectively. Melanoma recurrences were noted to be locoregional in 36% of cases and systemic in 64% of cases. Thirty percent of patients with locoregional relapse and 75% of patients with systemic relapse were detected solely by CT imaging. CONCLUSIONS:CT imaging alone detected the majority of sites of disease progression in our patients with high-risk cutaneous melanoma. This disease was not heralded by symptoms, physical examination, or blood work. Although the benefit of the early detection of advanced melanoma is unknown, this experience is relevant because of the rapid development and availability of potentially curative immunotherapies.

journal_name

Ann Surg Oncol

authors

Park TS,Phan GQ,Yang JC,Kammula U,Hughes MS,Trebska-McGowan K,Morton KE,White DE,Rosenberg SA,Sherry RM

doi

10.1245/s10434-017-5768-8

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

947-951

issue

4

eissn

1068-9265

issn

1534-4681

pii

10.1245/s10434-017-5768-8

journal_volume

24

pub_type

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