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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2007

01-06-2007 | Melanomas

Detection of First Relapse in Cutaneous Melanoma Patients: Implications for the Formulation of Evidence-Based Follow-up Guidelines

Authors: Anne Brecht Francken, MD, Helen M. Shaw, PhD, Neil A. Accortt, PhD, Seng-Jaw Soong, PhD, Harald J. Hoekstra, MD, John F. Thompson, MD

Published in: Annals of Surgical Oncology | Issue 6/2007

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Abstract

Background

The value of follow-up surveillance for patients with cutaneous melanoma remains uncertain. In this prospective study the frequency of detection of first melanoma recurrence (FMR) by patient or doctor was analyzed to assist in the future design of evidence-based follow-up guidelines.

Methods

Patients who had a recurrence of a previously treated American Joint Committee on Cancer (AJCC) stage I–III primary melanoma (PM) were interviewed to ascertain how their PM and FMR were detected. Factors predicting the detection of PM and FMR were analyzed.

Results

The study group comprised 211 patients. In 168 patients, information on detection of their PM was available; 102 PMs (61%) were detected by the patient and 18 (11%) by their partner. Higher AJCC stage, visible location for the patient, and female sex were independent predictive factors for patient-detected PM (P = .03, .002, and .02 respectively). The FMR type was local in 28 (13%), in transit in 35 (17%), in regional lymph nodes in 97 (46%), and distant in 51 (24%). Seventy-three percent of all FMRs were detected by the patient. The presence of a symptom was the only independent predictor of a patient-detected FMR (P < .0001). There was no statistically significant survival difference between the patient-detected and doctor-detected FMRs.

Conclusions

Three-quarters of FMRs were detected by patients or their partners, and it should be possible to improve this rate even further by better education. More frequent follow-up visits are thus unlikely to be valuable. Reductions in follow-up frequency may therefore be safe and economically responsible.
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Metadata
Title
Detection of First Relapse in Cutaneous Melanoma Patients: Implications for the Formulation of Evidence-Based Follow-up Guidelines
Authors
Anne Brecht Francken, MD
Helen M. Shaw, PhD
Neil A. Accortt, PhD
Seng-Jaw Soong, PhD
Harald J. Hoekstra, MD
John F. Thompson, MD
Publication date
01-06-2007
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-007-9347-2

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