FOLLOW-UP REQUIREMENTS FOR THICK CUTANEOUS MELANOMA

The primary aim of postoperative melanoma follow-up is the early detec tion and treatment of treatable recurrences which gives a survival adv antage to these patients. The need for follow-up is universally accept ed. However, there is ongoing controversy about the duration of follow -up and frequency of reviews. We present a retrospective review of 244 patients with localised thick (greater than or equal to 4.0 mm) cutan eous melanoma, who had completed a 10-year follow-up or had died from their melanoma within 10 years. For these criteria, this is the larges t series of this type which has been reported to date. The incidence o f treatable recurrences peaked in the first postoperative year at 40% and then rapidly decreased, levelling off after year 5 at 2.5% per ann um. We believe that this high incidence of treatable recurrences reinf orces the need for 10-year follow-up of these patients. We also recomm end that the annual frequency of follow-up reviews in each year be bas ed on that year's risk for getting a treatable recurrence. Following t his principle, we provide an example of such a follow-up programme.