Cargando…
The meaning of screening: detection of brain metastasis in the adjuvant setting for stage III melanoma
BACKGROUND: The incidence of melanoma is increasing and 37% of patients with metastatic melanoma eventually have brain metastasis (BM). Currently, there is no consensus on screening for BM in patients with resected stage III melanoma. However, given the high incidence of BM, routine screening magnet...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808474/ https://www.ncbi.nlm.nih.gov/pubmed/36265261 http://dx.doi.org/10.1016/j.esmoop.2022.100600 |
_version_ | 1784862950929989632 |
---|---|
author | Derks, S.H.A.E. de Joode, K. Mulder, E.E.A.P. Ho, L.S. Joosse, A. de Jonge, M.J.A. Verhoef, C. Grünhagen, D.J. Smits, M. van den Bent, M.J. van der Veldt, A.A.M. |
author_facet | Derks, S.H.A.E. de Joode, K. Mulder, E.E.A.P. Ho, L.S. Joosse, A. de Jonge, M.J.A. Verhoef, C. Grünhagen, D.J. Smits, M. van den Bent, M.J. van der Veldt, A.A.M. |
author_sort | Derks, S.H.A.E. |
collection | PubMed |
description | BACKGROUND: The incidence of melanoma is increasing and 37% of patients with metastatic melanoma eventually have brain metastasis (BM). Currently, there is no consensus on screening for BM in patients with resected stage III melanoma. However, given the high incidence of BM, routine screening magnetic resonance imaging (MRI) of the brain is considered in patients with completely resected stage III melanoma before the start of adjuvant treatment. The aim of this study was to assess the yield of screening for BM in these patients. MATERIALS AND METHODS: A single-center cohort study was carried out in the Erasmus MC, Rotterdam, The Netherlands, a large tertiary referral center for patients with melanoma. Eligible patients with complete resection of stage III melanoma and a screening MRI of the brain, made within 12 weeks after resection and before adjuvant treatment (programmed cell death protein 1 inhibitors, dabrafenib–trametinib), available between 1 August 2018 and 1 January 2021, were included. RESULTS: A total of 202 patients were included. Eighteen (8.9%) of 202 patients had extracranial metastasis at screening. Two (1.1%) of the remaining 184 patients had BM at screening, resulting in a switch from adjuvant treatment to ipilimumab–nivolumab. At a median follow-up of 21.2 months, BM was detected in another 4 (2.4%) of 166 patients who started with adjuvant treatment. CONCLUSIONS: The yield of screening MRI of the brain is low after complete resection of stage III melanoma, before the start of adjuvant treatment. Therefore, routine screening MRI is not recommended in this setting. |
format | Online Article Text |
id | pubmed-9808474 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-98084742023-01-04 The meaning of screening: detection of brain metastasis in the adjuvant setting for stage III melanoma Derks, S.H.A.E. de Joode, K. Mulder, E.E.A.P. Ho, L.S. Joosse, A. de Jonge, M.J.A. Verhoef, C. Grünhagen, D.J. Smits, M. van den Bent, M.J. van der Veldt, A.A.M. ESMO Open Original Research BACKGROUND: The incidence of melanoma is increasing and 37% of patients with metastatic melanoma eventually have brain metastasis (BM). Currently, there is no consensus on screening for BM in patients with resected stage III melanoma. However, given the high incidence of BM, routine screening magnetic resonance imaging (MRI) of the brain is considered in patients with completely resected stage III melanoma before the start of adjuvant treatment. The aim of this study was to assess the yield of screening for BM in these patients. MATERIALS AND METHODS: A single-center cohort study was carried out in the Erasmus MC, Rotterdam, The Netherlands, a large tertiary referral center for patients with melanoma. Eligible patients with complete resection of stage III melanoma and a screening MRI of the brain, made within 12 weeks after resection and before adjuvant treatment (programmed cell death protein 1 inhibitors, dabrafenib–trametinib), available between 1 August 2018 and 1 January 2021, were included. RESULTS: A total of 202 patients were included. Eighteen (8.9%) of 202 patients had extracranial metastasis at screening. Two (1.1%) of the remaining 184 patients had BM at screening, resulting in a switch from adjuvant treatment to ipilimumab–nivolumab. At a median follow-up of 21.2 months, BM was detected in another 4 (2.4%) of 166 patients who started with adjuvant treatment. CONCLUSIONS: The yield of screening MRI of the brain is low after complete resection of stage III melanoma, before the start of adjuvant treatment. Therefore, routine screening MRI is not recommended in this setting. Elsevier 2022-10-17 /pmc/articles/PMC9808474/ /pubmed/36265261 http://dx.doi.org/10.1016/j.esmoop.2022.100600 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Original Research Derks, S.H.A.E. de Joode, K. Mulder, E.E.A.P. Ho, L.S. Joosse, A. de Jonge, M.J.A. Verhoef, C. Grünhagen, D.J. Smits, M. van den Bent, M.J. van der Veldt, A.A.M. The meaning of screening: detection of brain metastasis in the adjuvant setting for stage III melanoma |
title | The meaning of screening: detection of brain metastasis in the adjuvant setting for stage III melanoma |
title_full | The meaning of screening: detection of brain metastasis in the adjuvant setting for stage III melanoma |
title_fullStr | The meaning of screening: detection of brain metastasis in the adjuvant setting for stage III melanoma |
title_full_unstemmed | The meaning of screening: detection of brain metastasis in the adjuvant setting for stage III melanoma |
title_short | The meaning of screening: detection of brain metastasis in the adjuvant setting for stage III melanoma |
title_sort | meaning of screening: detection of brain metastasis in the adjuvant setting for stage iii melanoma |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9808474/ https://www.ncbi.nlm.nih.gov/pubmed/36265261 http://dx.doi.org/10.1016/j.esmoop.2022.100600 |
work_keys_str_mv | AT derksshae themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT dejoodek themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT muldereeap themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT hols themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT joossea themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT dejongemja themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT verhoefc themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT grunhagendj themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT smitsm themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT vandenbentmj themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT vanderveldtaam themeaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT derksshae meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT dejoodek meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT muldereeap meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT hols meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT joossea meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT dejongemja meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT verhoefc meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT grunhagendj meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT smitsm meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT vandenbentmj meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma AT vanderveldtaam meaningofscreeningdetectionofbrainmetastasisintheadjuvantsettingforstageiiimelanoma |