Primary staging and follow-up in melanoma patients - monocenter evaluation of methods, costs and patient survival

• Verfasst von: Hofmann, Udo [VerfasserIn]
• Verfasst von: Rittgen, Werner [VerfasserIn]
• Verfasst von: Jung, Ernst G. [VerfasserIn]
• Verfasst von: Schadendorf, Dirk [VerfasserIn]
• Titel: Primary staging and follow-up in melanoma patients - monocenter evaluation of methods, costs and patient survival
• Verf.angabe: U. Hofmann, M. Szedlak, W. Rittgen, E.G. Jung and D. Schadendorf
• E-Jahr: 2002
• Jahr: 2002 Jul 2
• Umfang: 7 S.
• Fussnoten: Gesehen am 11.11.2020
• Titel Quelle: Enthalten in: British journal of cancer
• Ort Quelle: Edinburgh : Nature Publ. Group, 1999
• Jahr Quelle: 2002
• Band/Heft Quelle: 87(2002), 2, Seite 151-157
• ISSN Quelle: 1532-1827
• DOI: doi:10.1038/sj.bjc.6600428
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1738462617

Abstract

In a German cohort of 661 melanoma patients the performance, costs and survival benefits of staging methods (history and physical examination; chest X-ray; ultrasonography of the abdomen; high resolution sonography of the peripheral lymph nodes) were assessed at initial staging and during follow-up of stage I/II+III disease. At initial staging, 74% (23 out of 31) of synchronous metastases were first detected by physical examination followed by sonography of the lymph nodes revealing 16% (5 out of 31). Other imaging methods were less efficient (Chest X-ray: one out of 31; sonography of abdomen: two out of 31). Nearly 24% of all 127 first recurrences and 18% of 73 second recurrences developed in patients not participating in the follow-up programme. In follow-up patients detection of first or second recurrence were attributed to history and physical examination on a routine visit in 47 and 52% recurrences, respectively, and to routine imaging procedures in 21 and 17% of cases, respectively. Lymph node sonography was the most successful technical staging procedure indicating 13% of first relapses, but comprised 24% of total costs of follow-up in stage I/II. Routine imaging comprised nearly 50% of total costs for follow-up in stage I/II and in stage III. The mode of detecting a relapse (‘patient vs. doctor-diagnosed’ or ‘symptomatic vs asymptomatic’) did not significantly influence patients overall survival. Taken together, imaging procedures for routine follow-up in stage I/II and stage III melanoma patients were inefficient and not cost-efficient.