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Does ultrasound-based follow-up improve survival of melanoma patients?
Does ultrasound-based follow-up improve survival outcomes of patients with stage 1-2 melanoma? A study in the European Journal of Cancer compared the efficacy of an ultrasound-based follow-up with a clinical follow-up to determine whether ultrasonography of the regional lymph nodes and abdomen improves melanoma-specific survival.
Different protocols have been used to follow up melanoma patients in stage 1-2 but there is no consensus on the complementary tests that should be requested, or the appropriate intervals between visits.
A total of 1,149 patients from Spain and Italy were included in the study, of which 554 were enrolled for a clinical follow-up and 595 patients were enrolled for a protocolised ultrasound follow-up. The average age of the patients was 53.8 years with a median follow-up time of 4.14 years.
During follow-up, disease progression was seen in 69 patients (12.5 percent) in the clinical follow-up cohort and 72 patients (12.1 percent) in the ultrasound follow-up cohort.
Median time to relapse for the first metastatic site was 2.11 years for skin metastases, 1.32 years for lymph node metastases, and 2.84 years for distant metastases. The pattern of progression and the total proportion of metastases were not significantly different in the two cohorts.
The study concluded that ultrasound-based follow-up does not increase survival outcomes for melanoma patients in stage 1-2. The study’s authors recommended clinical follow-up for patients in stage 1-2 after negative sentinel lymph node biopsy.
Ribero, S. et al. (November 2017.) Ultrasound-based follow-up does not increase survival in early-stage melanoma patients: A comparative cohort study. European Journal of Cancer. Volume 85, Pages 59–66. DOI: http://dx.doi.org/10.1016/j.ejca.2017.07.051.