Detection of first relapse in cutaneous melanoma patients: Implications for the formulation of evidence-based follow-up guidelines
Detection of first relapse in cutaneous melanoma patients: Implications for the formulation of evidence-based follow-up guidelines
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DOI：
10.1245/s10434-007-9347-2
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发表时间：
2007-06-01
影响因子：
3.7
通讯作者：
Thompson, John F.
中科院分区：
文献类型：
--
作者：
Francken, Anne Brecht;Shaw, Helen M.;Thompson, John F.
背景：皮肤黑色素瘤患者随访监测的价值仍不确定。在这项前瞻性研究的频率检测的第一个黑色素瘤复发（FMR）的患者或医生进行了分析，以协助在未来的设计，以证据为基础的后续guidelines. Methods：曾复发的美国癌症联合委员会（AJCC）阶段I-III原发性黑色素瘤（PM）的患者进行了采访，以确定他们的PM和FMR检测。结果：本组211例患者中，有11例发生了PM和FMR。在168例患者中，可获得关于其PM检测的信息; 102例PM（61%）由患者检测到，18例（11%）由其伴侣检测到。较高的AJCC分期、患者可见部位和女性是患者检测到PM的独立预测因素（P分别为0.03、0.002和0.02）。FMR类型为局部28例（13%），过境35例（17%），区域淋巴结97例（46%），远处51例（24%）。73%的FMR是由患者检测到的。症状的存在是患者检测到FMR的唯一独立预测因素（P <0.0001）。患者检测和医生检测的FMRs.Conclusions：四分之三的FMR的患者或他们的合作伙伴检测之间没有统计学上显着的生存差异，它应该是可能的，以提高这一比率，甚至进一步更好的教育。因此，更频繁的后续访问不太可能有价值。因此，减少随访频率可能是安全和经济的。
Background: The value of follow-up surveillance for patients with cutaneous melanoma remains uncertain. In this prospective study the frequency of detection of first melanoma recurrence (FMR) by patient or doctor was analyzed to assist in the future design of evidence-based follow-up guidelines.Methods: Patients who had a recurrence of a previously treated American Joint Committee on Cancer (AJCC) stage I-III primary melanoma (PM) were interviewed to ascertain how their PM and FMR were detected. Factors predicting the detection of PM and FMR were analyzed.Results: The study group comprised 211 patients. In 168 patients, information on detection of their PM was available; 102 PMs (61%) were detected by the patient and 18 (11%) by their partner. Higher AJCC stage, visible location for the patient, and female sex were independent predictive factors for patient-detected PM (P = .03, .002, and .02 respectively). The FMR type was local in 28 (13%), in transit in 35 (17%), in regional lymph nodes in 97 (46%), and distant in 51 (24%). Seventy-three percent of all FMRs were detected by the patient. The presence of a symptom was the only independent predictor of a patient-detected FMR (P < .0001). There was no statistically significant survival difference between the patient-detected and doctor-detected FMRs.Conclusions: Three-quarters of FMRs were detected by patients or their partners, and it should be possible to improve this rate even further by better education. More frequent follow-up visits are thus unlikely to be valuable. Reductions in follow-up frequency may therefore be safe and economically responsible.