Detecting metastatic melanoma with the five-year follow-up regime

ABSTRACT NUMBER: NESTAC MEDAL FOR MEDICAL STUDENTS_8

 

AUTHOR
Georgina Liu

MAIN ABSTRACT TEXT

Introduction
Malignant melanoma is the second commonest skin cancer among adults aged 25 to 49 years old. It is crucial for metastatic disease to be detected as early as possible, as the stage of melanoma correlates to the survival rate of patients. The objectives of this audit were to determine whether the inclusion of surveillance CT scans, recommended by the Melanoma NICE guidelines (2015), improved the detection of metastases during patients’ follow-up regime. This audit also analysed whether a five-year follow-up was sufficient time to detect 95% of cases of metastases.

Methods
Patients who presented with metastatic melanoma after excision of the primary disease between the years 2013 to 2017 were identified retrospectively and compared with a previous audit conducted in 2013. The time interval between excision of the primary melanoma to the first presentation of metastases, and the route by which this disease was discovered was analysed.

Results
The inclusion of surveillance CT scanning during follow-up had increased the percentage of metastases detected earlier. Only 84.7% of patients who developed metastatic disease were identified during the five-year follow-up.

Conclusion
A higher proportion of metastases were detected earlier through the addition of surveillance CT scans during follow-up. However, there was no significant increase in cases detected during the five-year period. It is therefore recommended to extend the follow-up to 9 years to account for 96.5% of total cases of metastases.