This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bastiaannet, E. Articles by Hoekstra, H. J. Search for Related Content PubMed PubMed Citation Articles by Bastiaannet, E. Articles by Hoekstra, H. J.

Level of Fluorodeoxyglucose Uptake Predicts Risk for Recurrence in Melanoma Patients Presenting With Lymph Node Metastases

¹ Department of Surgical Oncology, Groningen University Medical Center and University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
² Nuclear Medicine & PET Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
³ Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
⁴ Nuclear Medicine & PET Center, Groningen University Medical Center, Groningen, The Netherlands
⁵ Department of Surgical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Correspondence: Address correspondence and reprint requests to: Harald J. Hoekstra, MD, PhD; E-mail: h.j.hoekstra{at}chir.umcg.nl.

Background: The incidence of malignant melanoma has increased. Identification of additional prognostic factors may allow the development of individualized strategies. This multivariate analysis was undertaken to evaluate the potential role of the standard uptake value (SUV) in predicting disease-free and overall survival in melanoma patients with lymph node metastases.

Methods: All melanoma patients with palpable lymph node metastases who where referred for a fluorodeoxyglucose positron emission tomography scan were eligible. The SUV in the lymph node metastasis was calculated. Data were analyzed (Kaplan-Meier), and differences in cumulative survival and the disease-free rate were assessed (log-rank test). Univariate and multivariate analyses (Cox proportional hazard model) were performed to determine independent prognostic factors.

Results: There was no statistical difference in survival for the 38 patients with a high or low SUV_mean (P = .11). However, a significant difference was found in disease-free survival (P = .03). Ulceration of the primary melanoma (P = .023) was an independent predictor of survival. For the disease-free survival, multivariate Cox regression showed adjuvant radiation (P = .001), localization of the primary melanoma (P = .017), and a high SUV_mean (P = .009) as independent prognostic factors.

Conclusions: Disease-free survival of melanoma patients was prolonged in those with a low SUV_mean value (P = .03) in their lymph node metastasis, as compared with those with a high SUV_mean. However, this difference was not found for overall survival. In multivariate analysis, high SUV_mean was an independent prognostic factor (P = .009) for disease-free survival. Prospective research should determine whether patients with a high FDG uptake in melanoma lymph node metastases could benefit from adjuvant radiation treatment or chemotherapy.

Key Words: Fluorodeoxyglucose-Positron emission tomography • Standard uptake value • Melanoma • Lymph node metastases • Survival • Disease-free survival

This article has been cited by other articles:

				B. Krug, R. Crott, M. Lonneux, J.-F. Baurain, A.-S. Pirson, and T. Vander Borght Role of PET in the Initial Staging of Cutaneous Malignant Melanoma: Systematic Review Radiology, December 1, 2008; 249(3): 836 - 844. [Abstract] [Full Text] [PDF]