18F-FDG PET/CT Impact on Malignant Melanoma Patients Undergoing Staging and Restaging: A Single-University-Center Experience in a Real-World Setting.

The global increase in the incidence of malignant melanoma, without significant changes in the mortality rate, may be influenced by the changes in the diagnostic approach and criteria, and the impact of innovative therapies on the survival of patients. Advances in treatment options, influencing prolonged survival, are bringing up a strong need for close surveillance of melanoma patients. In this observational, retrospective, and single-center study, we determined the impact of 18F-FDG PET/CT diagnostics on the outcomes and survival of malignant melanoma patients at different stages from an extensive and unselected group in a real-life clinical management setting. A total number of 189 malignant melanoma patients who underwent 18F-FDG PET/CT examination in the course of the treatment at one university oncology institute during the period from January 2010 to December 2024 were included in the study, and the multifactorial impact on the outcome and survival of malignant melanoma patients was observed in regard to the differences resulting from the therapeutic approaches and the introduction of new therapeutic options and drugs. Our results indicate that 18F-FDG PET/CT is a sensitive imaging tool for the detection of predominantly distant metastases in malignant melanoma patients belonging to an extensive and unselected population in a real-world clinical setting, not only at advanced melanoma stages but also at early stages of high-risk patients' surveillance. Follow-up appears to be of substantial importance for patients at advanced stages, but also for patients at early stages of disease, in particular in the presence of a strong clinical suspicion. Immunotherapy and combined therapy are improving overall survival in melanoma patients in real-world circumstances and equivalent clinical surroundings.