期刊
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
卷 75, 期 3, 页码 516-524出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2016.02.1229
关键词
computed tomography scan; follow-up; magnetic resonance imaging; melanoma; melanoma-inhibitory activity; recurrences; S100B; ultrasonography
类别
资金
- Fondo de Investigaciones Sanitarias [P.I. 09/01393, P.I. 12/00840]
- CIBER on Rare Disease, Instituto de Salud Carlos III
- Fondo Europeo de Desarrollo Regional, Union Europea, Una manera de hacer Europa''
- Catalan Government [AGAUR 2009 SGR1337, AGAUR 2014 SGR603]
- Fundacio La Marato de TV3, Catalonia [201331-30]
- European Commission under Sixth Framework Program (GenoMEL) [LSHC-CT-2006-018702]
- European Commission under Seventh Framework Program (Diagnoptics)
- National Cancer Institute of the US National Institutes of Health [CA83115]
- Asociacion Espanola contra el Cancer Foundation
Background: There is no international consensus on optimal follow-up schedules and which supplementary tests should be used after resection of a primary melanoma. Objective: We sought to analyze the performance of the follow-up components and identify procedures that detect melanoma metastasis earlier. Methods: This was a prospective cohort from 290 consecutive patients given a diagnosis of stage IIB, IIC, and III melanoma. Patients were followed up with an intensive protocol based on imaging studies (computed tomography of the chest, abdomen, and pelvis, and brain magnetic resonance imaging), periodic laboratory tests, regular physical examinations, and patient self-examinations. Results: A total of 2382 clinical examinations and 3069 imaging tests were performed. The patients completed 899.8 person-years of follow-up, with a median of 2.5 years. In all, 115 recurrences in 290 patients were recorded, of which computed tomography detected 48.3%; brain magnetic resonance imaging, 7.6%; laboratory test, 2.5%; physician, 23.7%; and patient, 17.8%. Limitations: Patients with stage III melanoma were not systematically classified into subgroups and overall survival was not evaluated. Conclusion: We observed that this intensive monitoring is appropriate for early detection of recurrence in stage IIB, IIC, and III melanoma. Prompt diagnosis of metastasis and the recent development of new therapeutic targets may improve overall survival.
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