[Detection of melanoma relapse: a retrospective study of 100 patients]

There is no international consensus on practical methods of monitoring melanoma following surgical removal of a primary tumour. The chief aim of such monitoring is to ensure detection of relapse where early diagnosis is crucial for survival (i.e. in-transit and lymph node metastases amenable to surgical removal) and the emergence of any first recurrence of primary melanoma.

The aim of our study was to identify the role of various agents and diagnostic tools both in first recurrence of primary melanoma and in clinical relapse of melanoma.

This was a retrospective study covering all patients with in-transit or regional lymph node metastasis seen between January 2005 and December 2007. The type of recurrence and method of detection were studied.

Ninety-four patients presented recurrence, with 66% of relapses comprising regional lymph node metastasis and 34% consisting of in-transit metastases. Thirty-three percent of cases of recurrence were detected by patients themselves, 21% by our department, 22% by a private dermatologist, 18% by a radiologist and 6% by a general practitioner. Fifty-four percent of recurrences among patients aged under 50 years were self-detected compared to 18% among patients aged over 70 years. A second melanoma was detected in six patients.

This study underscores the great importance of self-examination in melanoma follow-up with over one third of recurrences being self-detected by patients. Self-examination was more effective for younger patients, emphasizing the need to increase awareness among older patients. This study also demonstrates the essential part played by dermatologists in terms of regular follow-up of melanoma.