Better surveillance to detect early recurrence

This study evaluated whether there are specific, high-risk periods a melanoma can return (recur) and spread to distant organs of the body (metastasize).

Melanoma is a type of skin cancer that originates in the melanocytes (pigment producing cells of the skin). Often, particularly in the early stages, when the melanoma is confined to the skin, treatment involves surgical removal of the melanoma and some healthy surrounding tissue to make sure all cancer cells are removed. However, some patients are still at risk of developing a melanoma recurrence (return of the cancer). Melanoma can recur at the same place as the original cancer site, or in distant organs and tissues such as the liver, lungs, bones or brain (metastases). Therefore, after removal of melanoma, patients are followed up regularly (surveillance), to detect early recurrence, which is easier to cure. However, for melanoma patients there is limited information regarding an optimal surveillance strategy. This study attempts to determine a time period when the risk of cancer recurrence is high. Therefore, a more efficient surveillance may be done, and patients' survival may be improved.

This trial included 11,615 patients diagnosed with early stage melanoma between 1970 and 2004. 40% (4,616) of these patients experienced at least one recurrence during the long-term follow up. Overall, the risk of recurrence was the highest 1 year after diagnosis. The risk of developing local recurrence (return of the cancer at the original site or in the nearby lymph nodes) was highest at 8 months after diagnosis, while risk of distant recurrence (return of the cancer in distant organs such as the lungs) was at 2 years after the diagnosis. Melanoma most commonly recurred in the distant skin (far from the first site) and lymph nodes (59% of patients with recurrence). The 5 and 10-year survival rates were 92.5% and 84.3%, respectively, in patients without any recurrence, while in patients with recurrent disease survival rates were 59.8% at 5 years and 38.9% at 10 years after the diagnosis. Also, patients who developed a recurrence at the original site had a better survival than patients who had lymph node and distant organ recurrence.

In summary, risk of melanoma recurrence is high and is highest at 1 year after diagnosis. Also, the site of recurrence influences patients’ survival. Therefore, surveillance programs should be intensive during the first year in order to allow early detection of potential recurrent disease, and improve survival.

In some of the patients, there was no data on lymph node involvement. This may have influenced the accuracy of the results.

Visit your doctor for regular, complete check-ups in order to detect early potential melanoma recurrence.