Data on First Recurrence after Treatment for Malignant Melanoma in a Large Patient Population

Fusi, Stefano; Ariyan, Stephan; Sternlicht, Andrew

doi:10.1097/00006534-199301000-00014

Cited by 75 publications

(52 citation statements)

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“…Eight out of 197 (4.1%) patients with a 'low risk' melanoma (pT 40.75 mm) relapsed; only two after the fifth year. The metastatic pattern of first relapse is shown in Figure 2 and was similar to other reports (Kersey et al, 1985;Fusi et al, 1993;Soong et al, 1998). Ninety-three patients with surgically resected loco-regional metastases (24 initial stage IIIA/B and 69 former stage I/II patients) were enrolled into the follow-up programme, in 60 out of 93 stage III patients a relapse was documented (64.5%) within a median time of 7.8 months.…”

Section: Recurrence Patternsupporting

confidence: 82%

Primary staging and follow-up in melanoma patients – monocenter evaluation of methods, costs and patient survival

et al. 2002

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In a German cohort of 661 melanoma patients the performance, costs and survival benefits of staging methods (history and physical examination; chest X-ray; ultrasonography of the abdomen; high resolution sonography of the peripheral lymph nodes) were assessed at initial staging and during follow-up of stage I/II+III disease. At initial staging, 74% (23 out of 31) of synchronous metastases were first detected by physical examination followed by sonography of the lymph nodes revealing 16% (5 out of 31). Other imaging methods were less efficient (Chest X-ray: one out of 31; sonography of abdomen: two out of 31). Nearly 24% of all 127 first recurrences and 18% of 73 second recurrences developed in patients not participating in the follow-up programme. In follow-up patients detection of first or second recurrence were attributed to history and physical examination on a routine visit in 47 and 52% recurrences, respectively, and to routine imaging procedures in 21 and 17% of cases, respectively. Lymph node sonography was the most successful technical staging procedure indicating 13% of first relapses, but comprised 24% of total costs of follow-up in stage I/II. Routine imaging comprised nearly 50% of total costs for follow-up in stage I/II and in stage III. The mode of detecting a relapse ('patient vs. doctor-diagnosed' or 'symptomatic vs asymptomatic') did not significantly influence patients overall survival. Taken together, imaging procedures for routine followup in stage I/II and stage III melanoma patients were inefficient and not cost-efficient.

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Section: Recurrence Patternsupporting

confidence: 82%

Primary staging and follow-up in melanoma patients – monocenter evaluation of methods, costs and patient survival

et al. 2002

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“…[588][589][590][600][601][602][603]. Median occurrence of regional lymph node metastases was earlier than in locoregional or distant metastases (recurrence-free survival 17.6 months vs. 23, respectively 25.9 months) [604].…”

Section: Background Information On the Clinical Decision Processmentioning

confidence: 95%

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

181

148

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“…2 Although some of this increasing incidence may be attributable to the detection of biologically early, indolent disease, the absolute number of patients who present with more advanced disease also is increasing. 3 Whereas previous investigators have reported that between 65% 4 and 81% 5 of melanoma metastases occur within 3 years after definitive treatment, the occurrence of metastases has been documented 10 years after treatment. 6,7 Although some risk factors for melanoma metastasis are known, such as tumor thickness and ulceration, currently, it is unknown whether these risk factors are of equal prognostic importance at different time intervals after definitive treatment.…”

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confidence: 98%

Characteristics associated with early and late melanoma metastases

Brauer

Wriston

Troxel

et al. 2009

Cancer

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BACKGROUND: Differences in risk factors for metastases at different time intervals after treatment have been described in several malignancies; however, to the authors' knowledge, no extensive study examining this issue in melanoma has been conducted to date. METHODS: The authors performed a nested case-control study of patients with melanoma who presented with only local disease. Patients in the case group included 549 patients who developed metastases 6 months after surgery. Of these, 320 patients developed metastasis within 3 years after undergoing definitive surgery (early metastases [EM]), and 70 patients developed metastasis 8 years after undergoing definitive surgery (late metastases [LM]). For each case, a control patient was chosen who had melanoma but who did not develop metastases in the same interval. Univariate and conditional multivariate logistic regression were used in the analysis of 34 clinical and tumor characteristics. RESULTS: Multivariate analysis confirmed previously established risk factors for metastases, such as increasing tumor thickness. In addition, the authors discovered that a personal history of nonmelanoma skin cancer (P ¼ .006) and a history of cancer other than skin cancer (P ¼ .020) also were associated with metastasis. In comparing the 320 EM patients with the 70 LM patients, EM patients were more likely to have thicker lesions (P < .001), ulcerated lesions (P ¼ .016), and a history of nonmelanoma skin cancer (P ¼ .024). CONCLUSIONS: In this study, 2 potentially novel risk factors for melanoma metastases were identified, and different profiles of risk factors were constructed for EM versus LM. These differences may be important in future risk identification and stratification for clinical trials and for the management and treatment of patients with melanoma.

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Data on First Recurrence after Treatment for Malignant Melanoma in a Large Patient Population

Cited by 75 publications

References 0 publications

Primary staging and follow-up in melanoma patients – monocenter evaluation of methods, costs and patient survival

Primary staging and follow-up in melanoma patients – monocenter evaluation of methods, costs and patient survival

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Characteristics associated with early and late melanoma metastases

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