Utility of 3-year Torso CT and Head Imaging in Asymptomatic Patients with High-Risk Melanoma
Identifieur interne : 004A09 ( Main/Exploration ); précédent : 004A08; suivant : 004A10Utility of 3-year Torso CT and Head Imaging in Asymptomatic Patients with High-Risk Melanoma
Auteurs : Erin R. Derose ; Alexander Pleet ; Wei Wang ; Virginia J. Seery ; Mee Young Lee ; Sharon Renzi ; Ryan J. Sullivan ; Michael B. AtkinsSource :
- Melanoma research [ 0960-8931 ] ; 2011.
Abstract
There is no general consensus regarding the optimal follow-up strategy for patients with melanoma. We sought to determine the utility and cost effectiveness of radiologic restaging of patients with stage IIB-IIIC melanoma at the 3-year follow-up time point.
A retrospective review of 210 patients diagnosed with stage IIB–IIIC melanoma seen in the Cutaneous Oncology Program at Beth Israel Deaconess Medical Center (BIDMC) between January, 2001 and July, 2006 was conducted. 52 patients were asymptomatic and continuously disease free and underwent re-staging head CT/MRI and torso CT scans three years after completion of local-regional therapy or initiation of adjuvant treatment. True positive, false positive and normal scans were identified and the cost per diagnosis calculated.
Fifty-five percent of patients followed at BIDMC recurred; 88% before 3 years (median time to recurrence 12 months, 95% CI: 10–16 months). The majority (69%) recurred with disease symptoms. Twenty five head CT scans, 27 head MRIs, and 52 torso CTs were performed. One false positive head CT and 5 abnormal torso CT scans (3 false positive, 2 true positive) were identified. The total cost per diagnosis was $312,990.
Extensive 3-year re-staging imaging appears to be of limited value for symptomatic and continuously disease free patients with stage IIB–IIIC melanoma. Furthermore, given the low risk of recurrence beyond 3 years, it is likely that subsequent routine imaging would have similarly low utility.
Url:
DOI: 10.1097/CMR.0b013e3283471086
PubMed: 21540750
PubMed Central: 3131441
Affiliations:
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Seery</name></author><author><name sortKey="Lee, Mee Young" sort="Lee, Mee Young" uniqKey="Lee M" first="Mee Young" last="Lee">Mee Young Lee</name></author><author><name sortKey="Renzi, Sharon" sort="Renzi, Sharon" uniqKey="Renzi S" first="Sharon" last="Renzi">Sharon Renzi</name></author><author><name sortKey="Sullivan, Ryan J" sort="Sullivan, Ryan J" uniqKey="Sullivan R" first="Ryan J." last="Sullivan">Ryan J. Sullivan</name></author><author><name sortKey="Atkins, Michael B" sort="Atkins, Michael B" uniqKey="Atkins M" first="Michael B." last="Atkins">Michael B. Atkins</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21540750</idno><idno type="pmc">3131441</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131441</idno><idno type="RBID">PMC:3131441</idno><idno type="doi">10.1097/CMR.0b013e3283471086</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">002A26</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002A26</idno><idno type="wicri:Area/Pmc/Curation">002A25</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002A25</idno><idno type="wicri:Area/Pmc/Checkpoint">002C45</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002C45</idno><idno type="wicri:Area/Ncbi/Merge">004325</idno><idno type="wicri:Area/Ncbi/Curation">004325</idno><idno type="wicri:Area/Ncbi/Checkpoint">004325</idno><idno type="wicri:doubleKey">0960-8931:2011:Derose E:utility:of:year</idno><idno type="wicri:Area/Main/Merge">004A41</idno><idno type="wicri:Area/Main/Curation">004A09</idno><idno type="wicri:Area/Main/Exploration">004A09</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Utility of 3-year Torso CT and Head Imaging in Asymptomatic Patients with High-Risk Melanoma</title><author><name sortKey="Derose, Erin R" sort="Derose, Erin R" uniqKey="Derose E" first="Erin R." last="Derose">Erin R. Derose</name></author><author><name sortKey="Pleet, Alexander" sort="Pleet, Alexander" uniqKey="Pleet A" first="Alexander" last="Pleet">Alexander Pleet</name></author><author><name sortKey="Wang, Wei" sort="Wang, Wei" uniqKey="Wang W" first="Wei" last="Wang">Wei Wang</name></author><author><name sortKey="Seery, Virginia J" sort="Seery, Virginia J" uniqKey="Seery V" first="Virginia J." last="Seery">Virginia J. Seery</name></author><author><name sortKey="Lee, Mee Young" sort="Lee, Mee Young" uniqKey="Lee M" first="Mee Young" last="Lee">Mee Young Lee</name></author><author><name sortKey="Renzi, Sharon" sort="Renzi, Sharon" uniqKey="Renzi S" first="Sharon" last="Renzi">Sharon Renzi</name></author><author><name sortKey="Sullivan, Ryan J" sort="Sullivan, Ryan J" uniqKey="Sullivan R" first="Ryan J." last="Sullivan">Ryan J. Sullivan</name></author><author><name sortKey="Atkins, Michael B" sort="Atkins, Michael B" uniqKey="Atkins M" first="Michael B." last="Atkins">Michael B. Atkins</name></author></analytic><series><title level="j">Melanoma research</title><idno type="ISSN">0960-8931</idno><idno type="eISSN">1473-5636</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">There is no general consensus regarding the optimal follow-up strategy for patients with melanoma. We sought to determine the utility and cost effectiveness of radiologic restaging of patients with stage IIB-IIIC melanoma at the 3-year follow-up time point.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">A retrospective review of 210 patients diagnosed with stage IIB–IIIC melanoma seen in the Cutaneous Oncology Program at Beth Israel Deaconess Medical Center (BIDMC) between January, 2001 and July, 2006 was conducted. 52 patients were asymptomatic and continuously disease free and underwent re-staging head CT/MRI and torso CT scans three years after completion of local-regional therapy or initiation of adjuvant treatment. True positive, false positive and normal scans were identified and the cost per diagnosis calculated.</p></sec><sec id="S3"><title>Results</title><p id="P3">Fifty-five percent of patients followed at BIDMC recurred; 88% before 3 years (median time to recurrence 12 months, 95% CI: 10–16 months). The majority (69%) recurred with disease symptoms. Twenty five head CT scans, 27 head MRIs, and 52 torso CTs were performed. One false positive head CT and 5 abnormal torso CT scans (3 false positive, 2 true positive) were identified. The total cost per diagnosis was $312,990.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Extensive 3-year re-staging imaging appears to be of limited value for symptomatic and continuously disease free patients with stage IIB–IIIC melanoma. Furthermore, given the low risk of recurrence beyond 3 years, it is likely that subsequent routine imaging would have similarly low utility.</p></sec></div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Atkins, Michael B" sort="Atkins, Michael B" uniqKey="Atkins M" first="Michael B." last="Atkins">Michael B. Atkins</name><name sortKey="Derose, Erin R" sort="Derose, Erin R" uniqKey="Derose E" first="Erin R." last="Derose">Erin R. Derose</name><name sortKey="Lee, Mee Young" sort="Lee, Mee Young" uniqKey="Lee M" first="Mee Young" last="Lee">Mee Young Lee</name><name sortKey="Pleet, Alexander" sort="Pleet, Alexander" uniqKey="Pleet A" first="Alexander" last="Pleet">Alexander Pleet</name><name sortKey="Renzi, Sharon" sort="Renzi, Sharon" uniqKey="Renzi S" first="Sharon" last="Renzi">Sharon Renzi</name><name sortKey="Seery, Virginia J" sort="Seery, Virginia J" uniqKey="Seery V" first="Virginia J." last="Seery">Virginia J. Seery</name><name sortKey="Sullivan, Ryan J" sort="Sullivan, Ryan J" uniqKey="Sullivan R" first="Ryan J." last="Sullivan">Ryan J. Sullivan</name><name sortKey="Wang, Wei" sort="Wang, Wei" uniqKey="Wang W" first="Wei" last="Wang">Wei Wang</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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