Recurrence patterns in patients with Stage II melanoma: The evolving role of routine imaging for surveillance
| Autor: | Lauren McGuire, Josh Bleicher, Maranda K Pahlkotter, Tawnya L. Bowles, Douglas S. Swords, Meghan E Mali, John R. Hyngstrom, Elliot A. Asare |
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| Rok vydání: | 2020 |
| Předmět: |
Diagnostic Imaging
Male medicine.medical_specialty Asymptomatic Systemic therapy 03 medical and health sciences 0302 clinical medicine Positron Emission Tomography Computed Tomography Utah Stage II melanoma medicine Humans In patient Stage (cooking) Melanoma Aged Neoplasm Staging Retrospective Studies business.industry Incidence Retrospective cohort study General Medicine Middle Aged medicine.disease Survival Rate Oncology Population Surveillance 030220 oncology & carcinogenesis Cohort Female 030211 gastroenterology & hepatology Surgery Radiology Neoplasm Recurrence Local medicine.symptom business Follow-Up Studies |
| Zdroj: | Journal of Surgical Oncology. 122:1770-1777 |
| ISSN: | 1096-9098 0022-4790 |
| Popis: | Background and objectives The relatively recent availability of effective systemic therapies for metastatic melanoma necessitates reconsideration of current surveillance patterns. Evidence supporting surveillance guidelines for resected Stage II melanoma is lacking. Prior reports note routine imaging detects only 21% of recurrent disease. This study aims to define recurrence patterns for Stage II melanoma to inform future surveillance guidelines. Methods This is a retrospective study of patients with Stage II melanoma. We analyzed risk factors for recurrence and methods of recurrence detection. We also assessed survival. Yearly hazards of recurrence were visualized. Results With a median follow-up of 4.9 years, 158 per 580 patients (27.2%) recurred. Overall, most recurrences were patient-detected (60.7%) or imaging-detected (27.3%). Routine imaging was important in detecting recurrence in patients with distant recurrences (adjusted rate 43.1% vs. 9.4% for local/in-transit; p = .04) and with Stage IIC melanoma (42.5% vs. 18.5% for IIA; p = .01). Male patients also self-detected recurrent disease less than females (52.1% vs. 76.8%; p Conclusions Routine imaging surveillance played a larger role in detecting recurrent disease for select groups in this cohort than noted in prior studies. In an era of effective systemic therapy, routine imaging should be considered for detection of asymptomatic relapse for select, high-risk patient groups. |
| Databáze: | OpenAIRE |
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