1136P - 18F-FDG-PET/CT imaging as survival predictor in patients with metastatic uveal melanoma

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Imaging, Diagnosis and Staging
Melanoma and other Skin Tumours
Presenter Alejo Rodriguez-Vida
Authors A. Rodriguez-Vida1, E. Muñoz2, M. Ochoa de Olza1, S. Rossi3, C. Gamez3, J.M. Caminal4, J. Perez1, J. Cortes2, J.R. Piulats1
  • 1Medical Oncology, Institut Catala d'Oncologia L'Hospitalet, 08908 - L'Hospitalet de Llobregat/ES
  • 2Medical Oncology, Hospital Valle de Hebron, 08035 - Barcelona/ES
  • 3Nuclear Medicine, Hospital Universitario de Bellvitge, 08907 - L'Hospitalet de Llobregat/ES
  • 4Ophthalmology, Hospital Universitario de Bellvitge, 08907 - L'Hospitalet de Llobregat/ES

Abstract

Aims

To correlate metabolic activity by 18F-FDG-PET/CT with survival in uveal melanoma patients with liver metastases (LM).

Methods

We undertook a retrospective study of 34 patients with uveal melanoma and LM who underwent a 18F-FDG-PET/CT at the time of metastatic diagnosis. Metabolic activity of LM was measured by standardized uptake value (SUV) and by grouping in 18F-FDG-PET-negative (lower or same metabolic activity in LM than in normal liver parenchyma (NLP) comparing to 18F-FDG-PET-positive (higher metabolic activity in LM than in NLP). These measures were correlated with overall survival (OS).

Results

Patients were treated in 2 institutions between 2004-2010. There were 19 women and 15 men. Median age was 62 years (30-84). Median follow-up was 16.7 months. Treatment of primary tumor was: 15 enucleation (44.1%), 3 resection (8.8%) and 16 brachytherapy (47.1%). LM were diagnosed on screening protocol and histologically confirmed if possible (85.3%). Median major diameter of LM was 20 mm (9-130). Median maximum SUV of LM was 8.7 (2-25). 18F-FDG-PET/CT was negative for metabolic activity in 6 patients and positive in 28 patients. All 6 patients with negative 18F-FDG-PET/CT were histologically confirmed. Metastatic disease treatments were: chemotherapy (27 patients), liver surgery (9 patients), liver stereotactic radiotherapy (2 patients), liver radiofrequency ablation (1 patient). Median OS was 18.8 months (CI 95% 7.2-30.4). Median OS was significantly higher (p = 0.001) in patients with 18F-FDG-PET-negative (median not reached) than in patients with 18F-FDG-PET-positive (15.1 months, CI 95% 11.5-18.7). Assessed as a continuous variable, maximum SUV in the liver was correlated with OS (p = 0.002, HR 1.1, CI 95% 1.03-1.2). Maximum SUV greater than 5 was related with poor prognosis (p = 0.025). Major diameter of LM in 18F-FDG-PET/CT was significantly correlated with OS (p < 0.001). LM greater than 20 mm were related with poor prognosis (p < 0.001). By multivariate analysis, major diameter of LM (p < 0.001) and 18F-FDG-PET/CT status (p = 0.001) remained significant survival predictors.

Conclusion

Metabolically 18F-FDG-PET-negative liver metastases correlated with better OS in patients with metastatic uveal melanoma.

Disclosure

All authors have declared no conflicts of interest.