Prospective Evaluation of a Follow-Up Schedule in Cutaneous Melanoma Patients: Recommendations for an Effective Follow-Up Strategy

Abstract

The results of our study suggest that an elaborated follow-up schedule in cutaneous melanoma is suitable for the early detection of second primary melanomas and early recurrences. The intensity of clinical and technical examinations can be reduced during follow-up of patients in the primary tumor stages and may be intensified in locoregional disease. Recommendations for an effective follow-up strategy are outlined.

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

“…Randomized controlled trials do not exist. Present publications yield varying results, as the percentage of recurrences detected by patients themselves ranges from 20 to 75 % [109,116,299,590,608]. One group reported that 56 % of recurrences were diagnosed by a physician, while 60 % of those detected by patients were locoregional [589].…”

“…Some centers use brochures and videos in this context, and relatives are sometimes included in the instruction process [590,600,608]. Numerous publications on follow-up -some retrospective, others prospective analyses of a patient group at the respective center -also try to answer the question who actually detected potential recurrences [116,590,600,608]. Randomized controlled trials do not exist.…”

Optimal follow-up for melanoma

“…Taking medical history and physical examination seem to be the only cost-effective measures for patients with AJCC stage I and II melanoma [32,[35][36][37]. Other authors have recommended serum biomarkers as a routine follow-up investigation [10].…”

“…Consequently, present recommendations for stage III patients are even less evidence-based. Several studies have addressed the use of routine investigations in follow-up surveillance [10,32,[35][36][37][38][39][40][41]. Taking medical history and physical examination seem to be the only cost-effective measures for patients with AJCC stage I and II melanoma [32,[35][36][37].…”

“…Several authors have investigated and discussed the topic of follow-up for melanoma patients [8][9][10]. To date, no international consensus has been reached regarding the optimal follow-up schedule, nor the extent of investigations.…”