Surveillance testing in patients with primary malignant melanoma

There are, at this time, no fully published prospective randomized studies of follow-up strategies for patients with primary malignant melanoma. However, four recent retrospective studies indicated that greater than 90% of melanoma recurrences were detected by history and/or physical examination, and that detection of recurrent melanoma by blood tests, chest X-ray, or CT scan rarely led to long-term survival. Based on the results of the above studies, recommendations for follow-up as developed by the National Institute of Health Consensus Panel on Early Melanoma can be considered. These include: 1) history and physical examination (including total body skin examination) at regular intervals; 2) the consideration of initial screening for first degree family members of patients with melanoma; and 3) on-going education for patients to recognize the signs of local and regional recurrences.