Investigating the benefit of frequent surveillance imaging on the survival outcomes in patients with resected stage III melanoma.

This study investigated the benefit of frequent surveillance imaging on the survival outcomes in patients with resected stage III melanoma. The data showed that patients who underwent less frequent imaging (12-monthly) had better outcomes than those who underwent more frequent imaging (3- to 4-monthly).

Melanoma is a form of aggressive skin cancer. Treatment commonly includes surgery to remove the tumor. Stage III melanoma has a high risk of spreading to distant parts of the body (metastasis) even after it is removed. It commonly spreads to the brain. Early detection of metastases is important for effective treatment.

Stage III melanoma is associated with a high rate of recurrences. Follow-up of patients at high risk of cancer recurrences helps to detect the disease soon after it appears. This improves treatment options and outcomes. Recent studies have shown that metastasis can be detected by computed tomography (CT) scanning or positron emission tomography (PET)/CT scanning. It is not known how often patients should have a CT or PET/CT scan or how long follow-up should be in patients with stage III resected melanoma. Therefore, it is important to investigate whether there is a survival benefit associated with frequent surveillance imaging in patients with resected stage III melanoma.

This study involved 473 patients with resected stage III melanoma. CT scan was the most used imaging technique (85%) compared to PET/CT scan (15%). Patients were divided into 3 groups according to the frequency of imaging schedules. Group 1 included 30% of the patients who underwent 3- to 4-monthly imaging. Group 2 included 10% of the patients who underwent 6-monthly imaging. Group 3 included 60% of the patients who underwent 12-monthly imaging. The average follow-up time was 6.2 years.

Overall, 53% of the patients had cancer spread to distant organs far from the original cancer site (distant recurrence). 40% of cancer spreading to distant organs was detected by CT or PET/CT, 43% was detected clinically, and 17% was detected with another imaging technique (MRI, X-ray, or ultrasound).

The average survival without cancer spreading to distant organs was 5.1 years. Among 139 patients with stage IIIC disease who had cancer spread to distant organs, the average survival after stage IV diagnosis and without worsening of melanoma was shorter in group 1 compared to group 3 (11.6 months vs 16 months).

The average overall survival was 7.4 years. In the patients with stage IIIB and stage IIIC disease, the average overall survival was shorter in group 1 compared to group 2.

This study concluded that patients with resected stage III melanoma who underwent less frequent imaging (12-monthly) had better outcomes than those who underwent more frequent imaging (3- to 4-monthly).

This study looked back in time at medical records. The comparison of the 3 imaging frequency schedules was not randomized. This study only included patients treated at a single institution in Australia. A randomized controlled study is needed to validate the conclusions.