Prognostic values of 18F-FDG PET/CT metabolic parameters combined with clinical pathological in-dicators in cutaneous malignant melanoma
Objective To discuss the relationship between 18F-FDG PET/CT metabolic parameters and clinical pathological indicators and prognosis in cutaneous malignant melanoma(CMM).Methods A total of 100 CMM patients(62 males,38 females,age(56.5±2.5)years)who underwent 18F-FDG PET/CT scans at the Second Xiangya Hospital of Central South University from August 2013 to November 2022 were retrospectively enrolled.Clinical pathological indicators(such as primary site,TNM staging,sentinel lymph node(SLN)status)and metabolic parameters(SUVmax,metabolic tumor volume(MTV),total le-sion glycolysis(TLG),whole-body MTV(wb-MTV),and whole-body TLG(wb-TLG))were collected.ROC curve analyses were used to determine the PET parameters thresholds for progression-free survival(PFS)and melanoma-specific survival(MSS).Kaplan-Meier survival analysis,univariate and multivariate Cox proportional hazards regression models were used to analyze the prognosis of patients'PFS and MSS,and a nomogram survival prediction model was constructed.Results Results of ROC curve analyses showed that the thresholds of SUVmax of primary tumor(p-SUVmax),MTV of primary tumor(p-MTV),TLG of pri-mary tumor(p-TLG),wb-MTV and wb-TLG for predicting PFS and MSS were 7.13,2.24 cm3,6.98 g,2.57 cm3,8.04 g and 9.09,2.34 cm3,7.44 g,2.24 cm3,9.17 g,respectively.Results of univariate analy-sis indicated that several clinical pathological indicators and metabolic parameters were prognostic risk fac-tors for PFS and MSS.Results of multivariate analysis indicated that metastases of SLN(hazard ratio(HR)=2.54,95％CI:1.09-5.90;P=0.030)and wb-TLG＞8.04 g(HR=2.58,95％CI:1.17-5.72;P=0.019)were independent prognostic risk factors for PFS,while metastases of SLN(HR=4.53,95％CI:1.54-13.35;P=0.006)and wb-TLG＞9.17 g(HR=2.48,95％CI:1.26-4.89;P=0.009)were independent risk prog-nostic factors for MSS.A nomogram survival prediction model based on PET metabolic parameter(wb-TLG)and clinical pathological indicator(SLN status)can effectively predict the prognosis of CMM patients.Con-clusions Clinical pathological parameters and PET parameters are associated with the prognosis of CMM patients.SLN status is critical for prognosis.
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