Evidence Suggests Less Frequent Follow-Up OK for Melanoma

Needs of patients, clinicians may be better served with fewer visits and a more focused approach

TUESDAY, Nov. 8 (HealthDay News) -- Implementation of a less frequent monitoring schedule for follow-up after treatment of localized melanoma, requiring fewer clinic visits, results in a small difference in the modeled delay of diagnosis of recurrence or new primaries, according to a study published online Nov. 7 in the Journal of Clinical Oncology.

Robin M. Turner, Ph.D., from The University of Sydney in Australia, and colleagues aimed to develop evidence-based guidelines for the frequency of patient follow-up after treatment of localized (American Joint Committee on Cancer [AJCC] stage I or II) cutaneous melanoma. Between January 1985 and December 2009, data were collected from 3,081 patients diagnosed by excision biopsy at the Melanoma Institute in Australia.

The investigators found that, within 10 years of initiating follow-up, 229 out of 1,000 patients developed recurrence, and 61 developed a new primary tumor. Following a schedule that involves fewer visits than recommended by current guidelines (3,000 fewer visits per 1,000 patients), only a small variance in modeled delay in diagnosis was observed (extra 44.9 and 9.6 patients per 1,000 for recurrence and new primary, respectively, with delay greater than two months). The most significant predictor of recurrence was AJCC substage, while those of developing a new primary were age and date of primary diagnosis.

"By providing less intensive monitoring, more efficient follow-up strategies are possible. Fewer visits with a more focused approach may address the needs of patients and clinicians to detect recurrent or new melanoma," the authors write.

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