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Titolo:
Earlier diagnosis sf second primary melanoma confirms the benefits of patient education and routine postoperative follow-up
Autore:
DiFronzo, LA; Wanek, LA; Morton, DL;
Indirizzi:
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:
CANCER
fascicolo: 8, volume: 91, anno: 2001,
pagine: 1520 - 1524
SICI:
0008-543X(20010415)91:8<1520:EDSSPM>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
CUTANEOUS MALIGNANT-MELANOMA; MULTIPLE PRIMARY MELANOMAS; CANCERS;
Keywords:
melanoma; second primary; early diagnosis; follow-up; patient education;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
20
Recensione:
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
Citazione:
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

Abstract

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 25/11/20 alle ore 01:13:25