Research Provides Guidance for Stage III Melanoma Follow-Up
Suggests that beyond certain time frame, routine exams detect few first systemic relapses
THURSDAY, May 20 (HealthDay News) -- Stage III melanoma patients or their family members detect nearly half of first relapses -- substantially more than are detected by physicians or screening radiologic tests -- and routine physical exams beyond a certain time frame are likely to detect few first systemic relapses, according to a study in the May 20 Journal of Clinical Oncology.
Emanuela Romano, M.D., of Memorial Sloan-Kettering Cancer Center in New York City, and colleagues reviewed medical records for 340 melanoma patients with stage IIIA, IIIB or IIIC disease, who relapsed after exhibiting no sign of disease. The researchers assessed the timing of initial relapse, how it was detected, and the five-year relapse-free survival (RFS) for all stage III patients.
The leading site of first relapse was systemic (51 percent), followed by local/in-transit (28 percent), and regional nodal (21 percent). Relapses were detected by patients/family in 47 percent of cases, radiologic tests in 32 percent and physicians in 21 percent. Relapses occurred within two years for stage IIIC disease, while in stage IIIA local/in-transit and nodal recurrences occurred by 40 months and systemic recurrences as late as 71 months. In stage IIIB, relapses occurred over periods similar to stage IIIA without regard to site. Five-year RFS for stage IIIA, IIIB, and IIIC patients was 63 percent, 32 percent and 11 percent respectively.
"Our data suggest that routine physical examinations beyond three years for stage IIIA, two years for stage IIIB, and one year for stage IIIC patients and radiologic imaging beyond three years for stages IIIA and IIIB and two years for stage IIIC patients would be expected to detect few first systemic relapses," the authors write.