%0 Journal Article
%T Preoperative FDG-PET/CT Is an Important Tool in the Management of Patients with Thick (T4) Melanoma
%A Rodrigo Arrangoiz
%A Pavlos Papavasiliou
%A Carrie A. Stransky
%A Jian Q. Yu
%A Li Tianyu
%A Elin R. Sigurdson
%A Adam C. Berger
%A Jeffrey M. Farma
%J Dermatology Research and Practice
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/614349
%X 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. 1. Introduction Cutaneous malignancies constitute one of the most commonly diagnosed cancers in the United States (USA), comprising more than half of all cancers diagnosed each year [1]. Cutaneous melanoma represents approximately four percent of all skin cancers diagnosed each year, but accounts for approximately 75% of skin-cancer-related deaths. In the USA in the year 2010, 68,130 new cases of melanoma were diagnosed, with 8,700 patients dying of the disease [2]. The incidence is increasing dramatically. The age-adjusted incidence of invasive melanoma in the USA increased from approximately four per 100,000 to 18 per 100,000 in white males between 1973 and 1998 [3]. The incidence of cutaneous melanoma continues to increase dramatically, increasing in men more rapidly than any other malignancy, and in women more rapidly than any other malignancy except for lung cancer [4]. The lifetime risk of developing melanoma for someone born in the USA in the year 2000 is 1 in 41 for men and 1 in 61 for women [3]. 18-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is a useful functional imaging modality for the staging of melanoma and has a potential role in assessing response to therapy. Wahl et al. [5] and Kern [6] demonstrated that
%U http://www.hindawi.com/journals/drp/2012/614349/