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.
美国癌症联合委员会（AJCC）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）。虽然对高风险黑色素瘤患者进行影像学监测具有直观合理性，但支持数据有限，这些研究多为回顾性分析，且采用了不同的方法、时间表和终点指标。因此，不同皮肤科和肿瘤学机构在随访建议（尤其是影像学检查方面）缺乏统一性。尽管如此，大量回顾性和前瞻性数据支持对高风险患者进行影像学随访。目前，正电子发射断层扫描（PET）或全身计算机断层扫描（CT）均可作为合理的随访选择，而对于能够接受检查的患者，脑部磁共振成像（MRI）在检测脑转移方面更具优势。在当今有效全身治疗（EST）的时代，这些疗法能够超越领先时间偏倚改善无病生存期（DFS）和总生存期（OS），这凸显了影像学在检测EST不同应答模式和治疗复发中的作用，以及放射学肿瘤负荷评估的重要性。
Clinical and Imaging Follow-Up for High-Risk Cutaneous Melanoma: Current Evidence and Guidelines
肿瘤(癌症)患者之家