Abstract:
The most recent (eighth) edition of the American Joint Committee on Cancer (AJCC) staging system divides invasive cutaneous melanoma into two broad groups: \"low-risk\" (stage IA-IIA) and \"high-risk\" (stage IIB-IV). While surveillance imaging for high-risk melanoma patients makes intuitive sense, supporting data are limited in that they are mostly respective and used varying methods, schedules, and endpoints. As a result, there is a lack of uniformity across different dermatologic and oncologic organizations regarding recommendations for follow-up, especially regarding imaging. That said, the bulk of retrospective and prospective data support imaging follow-up for high-risk patients. Currently, it seems that either positron emission tomography (PET) or whole-body computerized tomography (CT) are reasonable options for follow-up, with brain magnetic resonance imaging (MRI) preferred for the detection of brain metastases in patients who can undergo it. The current era of effective systemic therapies (ESTs), which can improve disease-free survival (DFS) and overall survival (OS) beyond lead-time bias, has emphasized the role of imaging in detecting various patterns of EST response and treatment relapse, as well as the importance of radiologic tumor burden.
摘要:
美国癌症联合委员会(AJCC)的最新(第八版)分期系统将侵袭性皮肤黑色素瘤分为两大类:“低风险”(IA-IIA期)和“高风险”(IIB-IV期)。虽然高危黑色素瘤患者的监测成像具有直观的意义,支持数据是有限的,因为它们大多是各自的,使用了不同的方法,时间表,和端点。因此,不同的皮肤病学和肿瘤学组织对后续建议缺乏统一性,尤其是关于成像。那就是说,大部分回顾性和前瞻性数据支持高危患者的影像学随访.目前,似乎正电子发射断层扫描(PET)或全身计算机断层扫描(CT)是随访的合理选择,优选使用脑磁共振成像(MRI)来检测可以接受脑转移的患者。当前时代的有效系统疗法(EST),这可以提高无病生存率(DFS)和总生存率(OS),超越提前期偏差,强调了成像在检测各种模式的EST反应和治疗复发中的作用,以及放射学肿瘤负担的重要性。