Follow-up in patients with localised primary cutaneous melanoma

Lancet Oncol. 2005 Aug;6(8):608-21. doi: 10.1016/S1470-2045(05)70283-7.


Follow-up services for patients with localised cutaneous melanoma are widely discussed but there is no international consensus. Our aim was to discuss frequency and duration of follow-up, type of health professional involved, optimum intensity of routine investigation, and patients' satisfaction with follow-up. Searches of the published work were directed at publications between January, 1985, and February, 2004 on recurrences, subsequent primary melanoma, routine tests, and patients' satisfaction. In a selection of 72 articles, 2142 (6.6%) recurrences were reported, 62% of which were detected by the patients themselves. 2.6% of patients developed a subsequent primary melanoma. Most investigators do not support high-intensity routine follow-up investigations. Of the various follow-up investigations requested by physicians, only medical history and physical examination seem to be cost effective. Lymph-node sonography seems to be a promising method for detection, although survival benefit remains to be proven. Patients were found to be anxious about follow-up visits, although other research showed that provision of information to patients was much appreciated. Published work on the follow-up of patients with cutaneous melanoma has mainly been retrospective and descriptive. Recommendations can be given with only a low grade of evidence. For meaningful guidelines to be developed, prospective, high-quality methodological research is needed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Costs and Cost Analysis
  • Evidence-Based Medicine
  • Health Care Costs / statistics & numerical data
  • Humans
  • Melanoma / economics
  • Melanoma / pathology*
  • Neoplasm Metastasis / diagnosis
  • Neoplasm Recurrence, Local / diagnosis
  • Patient Satisfaction*
  • Physical Examination / economics
  • Practice Guidelines as Topic*
  • Practice Patterns, Physicians'*
  • Prognosis
  • Quality of Life
  • Skin Neoplasms / economics
  • Skin Neoplasms / pathology*
  • Survival Analysis
  • Treatment Outcome