Performance of diagnostic tests in an intensive follow-up protocol for patients with American Joint Committee on Cancer (AJCC) stage IIB, IIC, and III localized primary melanoma: A prospective cohort study - 17/08/16
Abstract |
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.
Le texte complet de cet article est disponible en PDF.Key words : computed tomography scan, follow-up, magnetic resonance imaging, melanoma, melanoma-inhibitory activity, recurrences, S100B, ultrasonography
Abbreviations used : AJCC, CT, IQR, MRI
Plan
| The study in the Melanoma Unit, Hospital Clinic, Barcelona, was supported in part by grants from Fondo de Investigaciones Sanitarias P.I. 09/01393 and P.I. 12/00840; CIBER on Rare Disease, Instituto de Salud Carlos III, co-funded by “Fondo Europeo de Desarrollo Regional, Unión Europea, Una manera de hacer Europa”; AGAUR 2009 SGR1337 and AGAUR 2014 SGR603 of the Catalan Government; a grant from “Fundació La Marató de TV3, 201331-30,” Catalonia; the European Commission under the Sixth Framework Program, contract no. LSHC-CT-2006-018702 (GenoMEL), under the Seventh Framework Program (Diagnoptics), and by the National Cancer Institute of the US National Institutes of Health (CA83115); and the Asociación Española contra el Cancer Foundation. The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; or in the preparation, review, or approval of the manuscript. |
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| Conflicts of interest: None declared. |
Vol 75 - N° 3
P. 516-524 - septembre 2016 Retour au numéro
Article précédent
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- Susan M. Swetter
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