Prognosis in Thin Melanoma Patients: Is Slightly Less Than Excellent Still Okay?

Excerpt

The postoperative visit for patients with melanoma is usually a simple affair. After a few postoperative visits with patients undergoing pancreatectomy, gastrectomy, or other gastrointestinal resections, it is nice to see melanoma patients looking and feeling well so quickly after surgery. The incision (usually) looks good, the pathology report shows no residual melanoma, and the question of ‘what next’ is a simple one to answer—no additional treatment, no laboratory tests or imaging studies, see your dermatologist regularly, and I will see you once a year. Of course, things get a little more nuanced for patients with high-risk stage II and III disease, but those conversations are a lot more hopeful than they were a decade ago. Nonetheless, in the back of my mind, there is that nagging little factoid that has been reported several times … yes, most patients with thin melanoma are cured, but most patients who die of melanoma are originally diagnosed with a thin melanoma.^1,2 However, that patient in front of you, at that moment of anxiety and vulnerability, does not need to hear about these epidemiologic quirks in the data. They just need to know if they are going to be okay, and, for the vast majority of patients, the answer is ‘yes’. …