Ultrasound-based follow-up does not increase survival in early-stage melanoma patients: A comparative cohort study. (November 2017)

• Record Type: Journal Article
• Authors: Ribero, S.; Podlipnik, S.; Osella-Abate, S.; Sportoletti-Baduel, E.; Manubens, E.; Barreiro, A.; Caliendo, V.; Chavez-Bourgeois, M.; Carrera, C.; Cassoni, P.; Malvehy, J.; Fierro, M.T.; Puig, S.
• Is Part Of: European journal of cancer. Volume 85(2017)
• Page Start: 59
• Page End: 66
• Publication Date: 2017-11
• Subjects: Melanoma -- Surveillance -- Follow-up -- Overall survival -- Ultrasonography -- Echography -- Sentinel lymph node -- Prognostic -- Recurrence; DFI disease free interval -- DMFS distant metastasis-free survival -- NMFS nodal metastasis-free survival -- DMFS distant metastasis-free survival -- MSS melanoma specific survival -- US Ultrasonograph; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2017.07.051
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Introduction: Different protocols have been used to follow up melanoma patients in stage I–II. However, there is no consensus on the complementary tests that should be requested or the appropriate intervals between visits. Our aim is to compare an ultrasound-based follow-up with a clinical follow-up. Patients and methods: Analysis of two prospectively collected cohorts of melanoma patients in stage IB–IIA from two tertiary referral centres in Barcelona (clinical-based follow-up [C-FU]) and Turin (ultrasound-based follow-up [US-FU]). Kaplan–Meier curves were used to evaluate distant metastases-free survival (DMFS), disease-free interval (DFI), nodal metastases-free survival (NMFS) and melanoma-specific survival (MSS). Results: A total of 1149 patients in the American Joint Committee on Cancer stage IB and IIA were included in this study, of which 554 subjects (48%) were enrolled for a C-FU, and 595 patients (52%) received a protocolised US-FU. The median age was 53.8 years (interquartile range [IQR] 41.5–65.2) with a median follow-up time of 4.14 years (IQR 1.2–7.6). During follow-up, 69 patients (12.5%) in C-FU and 72 patients (12.1%) in US-FU developed disease progression. Median time to relapse for the first metastatic site was 2.11 years (IQR 1.14–4.04) for skin metastases, 1.32 (IQR 0.57–3.29) for lymph node metastases and 2.84 (IQR 1.32–4.60) for distant metastases. The pattern of progression and the total proportion of metastases were not significantly different ( P = .44) in the two centres. No difference in DFI, DMFS, NMFS and MSS was found between the two cohorts. Conclusion: Ultrasound-based follow-up does not increase the survival of melanoma patients in stage IB–IIA. Highlights: Ultrasonography (US) of the regional lymph nodes and US of the abdomen do not improve melanoma-specific survival. Ultrasound-based follow-up does not increase survival of melanoma patients in stage IB–IIA. Our recommendation for patients in stage IB–IIA after negative sentinel lymph node biopsy is to perform clinical follow-up.