Patterns and timing of initial relapse in pathologic stage II melanoma patients Journal Article


Authors: Lee, A. Y.; Droppelmann, N.; Panageas, K. S.; Zhou, Q.; Ariyan, C. E.; Brady, M. S.; Chapman, P. B.; Coit, D. G.
Article Title: Patterns and timing of initial relapse in pathologic stage II melanoma patients
Abstract: Purpose: Pathologic stage II melanoma patients have variable outcomes when divided by substage. We hypothesized that an understanding of the patterns of initial relapse by substage will better inform follow-up guidelines. Methods: We performed a retrospective review of 738 adult patients with pathologic stage II cutaneous melanoma treated at Memorial Sloan Kettering Cancer Center between 1993 and 2013. Clinical records were reviewed to determine time, location, and method of detection of initial relapse. Results: At a median follow-up of 52 months, 219 patients relapsed. Relapses were detected more frequently in higher substages. Initial relapses were most commonly local/in-transit for IIA and IIB and systemic for IIC. Lung and brain were the most frequent sites of systemic relapse. Patient-detection was the most common method of relapse detection (59%) in all substages. The 5-year cumulative incidence for patient-detected relapse was 13.6% for IIA, 18.9% for IIB, and 23.3% for IIC and for image-detected relapse was 3.4, 7.9, and 16.6%, respectively. The 5-year cumulative incidence for physician-detected relapse was less than 10% across all substages and leveled off at 3 years for stage IIA and IIB and 2 years for stage IIC. Conclusions: Relapses were most frequently patient-detected in all stage II substages, highlighting the importance of patient education and self-examination. The highest yield for routine imaging is in stage IIC patients during the first 4 years. Physician examination is unlikely to detect relapses beyond 3 years for stage IIA and IIB and beyond 2 years for stage IIC patients. © 2016, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 24
Issue: 4
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2017-04-01
Start Page: 939
End Page: 946
Language: English
DOI: 10.1245/s10434-016-5642-0
PROVIDER: scopus
PUBMED: 27804026
PMCID: PMC5505631
DOI/URL:
Notes: Article -- Export Date: 4 April 2017 -- Source: Scopus
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MSK Authors
  1. Qin Zhou
    120 Zhou
  2. Paul Chapman
    246 Chapman
  3. Katherine S Panageas
    327 Panageas
  4. Mary Sue Brady
    164 Brady
  5. Charlotte Eielson Ariyan
    77 Ariyan
  6. Daniel Coit
    415 Coit
  7. Ann Yeelin Lee
    9 Lee