Less frequent follow-ups OK for melanoma patients

Sydney - A new study suggests that less frequent post-treatment monitoring visits for melanoma patients makes only a small difference in the modeled delay of diagnosis of recurrence or new primaries.

To develop evidence-based guidelines for follow-up frequency for stage I or II cutaneous melanoma patients, a University of Sydney research team analyzed data on 3,081 such patients diagnosed between January 1985 and December 2009. Kaplan-Meier curves and Cox models were used to characterize the time course and predictors for recurrence and new primaries, according to the study published in the online Journal of Clinical Oncology. The team used two monitoring schedules to model delay in diagnosis of recurrence or new primary as well as the number of monitoring visits required: first, with visits scheduled according to 2008 Australian and New Zealand guidelines and, second, with fewer visits, especially for those at lowest risk of recurrence.

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. But with a schedule of fewer visits than recommended by current guidelines (3,000 fewer visits per 1,000 patients), researchers found only a small variance in modeled delay in diagnosis: 44.9 per 1,000 for recurrence and 9.6 per 1,000 for new primary, with delay greater than two months.

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

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