Time and frequency of recurrence of cutaneous stage I malignant melanoma with guidelines for follow-up study

This study is based upon 3,171 patients with clinical Stage I cutaneous malignant melanoma treated at the Sydney Melanoma Unit (SMU) in Australia. The mean follow-up period was 9.8 years, ranging from 2.5 to 36.2 years. During the course of this follow-up study, recurrence developed in 886 patients. Three factors that predicted both the risk of recurrence and the disease-free interval were determined. These were thickness of tumor, the first definitive surgical treatment (whether or not the patient underwent elective dissection of lymph nodes) and the ulcerative state of the primary tumor. Follow-up schedules were designed taking all three of the factors into consideration. The schedules so derived reflected both the risk of recurrence and its alteration with time. It will obviously be necessary, however, to modify the frequency of follow-up visits according to the institutional resources available and the specific wishes of the patient. Annual review for an indefinite period for all patients with melanoma is recommended to detect both additional cancers and late recurrences.