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Study suggests timing of examinations to detect first stage III melanoma relapse
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Almost half of first relapses in patients with stage III melanoma were detected by the patients themselves or their families, according to a new study. The analysis suggested that conducting routine examinations beyond 3 years for stage IIIA, 2 years for stage IIIB and 1 year for stage IIIC patients will find few first relapses.
“The few published studies looking at follow-up of stage III patients have either been relatively small or have not reported sites of first relapse,” researchers wrote. “This makes it difficult to know how best to follow these patients to optimize the chance of detecting the initial relapse.”
In the study, researchers examined the records from 340 stage III melanoma patients seen at Memorial Sloan-Kettering Cancer Center who ultimately relapsed.
The site of first relapse was local/in-transit in 28% of patients, regional nodal in 21% and systemic in 51%. Overall, the patient or family detected the relapse in 47% of cases, physicians detected the relapse in 21% and radiologic tests detected the relapse in 32%.
The 5-year OS rates for stages IIIA, IIIB and IIIC from time of first relapse were 20%, 20% and 11%, respectively. Patients with first relapse being local/in-transit had better OS.
“Although our data do not address how frequently physical examinations should be done, they suggest that frequent physical examinations beyond 3 years for stage IIIA, 2 years for stage IIIB, and 1 year for stage IIIC patients are unlikely to detect a first relapse,” the researchers wrote. “Our data indicated that neither more intense nor more frequent follow-up is associated with discovery of resectable first relapses.”
For more information:
- Romano E. J Clin Oncol. 2010;10.1200/JCO.2009.26.2063.