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Earlier diagnosis sf second primary melanoma confirms the benefits of patient education and routine postoperative follow-up
DiFronzo, LA; Wanek, LA; Morton, DL;
St Johns Hlth Ctr, John Wayne Canc Inst, Roy E Coats Res Labs, Santa Monica, CA 90404 USA St Johns Hlth Ctr Santa Monica CA USA 90404 s, Santa Monica, CA 90404 USA
Titolo Testata:
fascicolo: 8, volume: 91, anno: 2001,
pagine: 1520 - 1524
melanoma; second primary; early diagnosis; follow-up; patient education;
Tipo documento:
Settore Disciplinare:
Clinical Medicine
Life Sciences
Indirizzi per estratti:
Indirizzo: Morton, DL St Johns Hlth Ctr, John Wayne Canc Inst, Roy E Coats Res Labs, 2200 Santa Monica Blvd, Santa Monica, CA 90404 USA St Johns Hlth Ctr 2200 Santa Monica Blvd Santa Monica CA USA 90404
L.A. DiFronzo et al., "Earlier diagnosis sf second primary melanoma confirms the benefits of patient education and routine postoperative follow-up", CANCER, 91(8), 2001, pp. 1520-1524


BACKGROUND. Rising health care costs have caused providers to question thebenefit of regular follow-up after treatment for patients with early stagecutaneous melanoma. The authors hypothesized that routine reassessment andcareful education of these patients would facilitate earlier diagnosis of a subsequent second primary melanoma, as reflected by reduced thickness of that lesion. METHODS. A prospective melanoma data base was used to identify patients who developed a second primary melanoma after treatment for American Joint Committee on Cancer (AJCC) Stage I or II cutaneous melanoma. After excision of the initial primary melanoma, all patients underwent routine biannual follow-up for new primary lesions. Follow-up consisted of a questionnaire and a complete skin examination by a physician. In addition, patients were regularly educated regarding the increased risk of developing a second melanoma. A paired t test was used to examine AJCC stage, thickness, and level of invasion of the initial melanoma compared with the second primary melanoma. RESULTS, Of 3310 patients with AJCC Stage I or II melanoma, 114 patients (3.4%) developed a second primary melanoma. AJCC staging of both first and second melanomas was available in 82 patients (72%). When the AJCC stages offirst and second melanomas were compared, 39 of 82 patients (48%) had lower stage second primary lesions, and 41 (50%) had same-stage second primary lesions. The mean tumor thickness was 1.32 +/- 1.02 mm for the initial melanoma, decreasing to 0.63 +/- 0.52 mm for the second melanoma; in fact, tumor thickness increased in only 4 of 51 patients (8%) whose records containeddata for both first and second melanomas. Similarly, the level of invasiondecreased in 60% of patients, remained the same in 27% of patients, and increased in only 13% of patients. By paired t test, the differences in AJCC stage, tumor thickness, and level of invasion between first and second melanomas were each highly significant (P = 0.0001). CONCLUSIONS. In this study, the second primary melanoma in patients with aprior cutaneous melanoma was significantly thinner than the initial primary lesion. This is evidence that careful follow-up and patient education allow earlier diagnosis. All patients diagnosed with cutaneous melanoma shouldbe counseled regarding the risks of second melanoma and should undergo lifelong follow-up at biannual intervals. Cancer 2001;91:1520-4. (C) 2001 American Cancer Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/21 alle ore 20:25:23