Follow-up of patients with a thin melanoma

Abstract

Abstract Background The aim of this study was to determine the value of follow-up in two subgroups of patients with a thin melanoma less than 0·76 mm and 0·76–1·5 mm thick. Methods The study group comprised all patients presenting to the Cardiff Melanoma Clinic from its introduction in 1976 to the end of 1994. All patients attend follow-up according to a strict protocol, determined by the thickness of the original melanoma (less than 0·76 mm, annually; more than 0·76 mm, every 2 months for 2 years, 3 monthly for 2 years, 4 monthly for 1 year and then annually). Results In total there were 306 patients with a thin melanoma: 178 with a melanoma thinner than 0·76 mm (group 1) and 128 with a melanoma of 0·76–1·5 mm (group 2). The groups were well matched for age (mean 50·6 (range 8–87) versus 50·6 (range 19–89) years respectively) and length of follow-up (mean 88·6 (range 4–296) versus 80·4 (range 2–296) months). Four patients (2·2 per cent) developed recurrence in group 1 and 16 (12·5 per cent) in group 2. The mean time to recurrence was 84·5 (range 49–143) months in group 1 and 45·3 (range 2–74) months in group 2. All patients in group 1 and 14 of 16 in group 2 died from recurrent disease. Conclusion Follow-up of patients with a melanoma less than 0·76 mm thick is not worthwhile. All recurrences would have been detected by annual review for 7 years in patients with melanomas between 0·76 and 1·5 mm thick.