A reduced follow-up strategy after treatment for American Joint Committee on Cancer (AJCC) stages IB to IIC melanoma was safe and patient acceptance was high. These findings from an international phase 3 randomized trial were published in the Annals of Surgical Oncology.

A total of 207 patients were enrolled in the United Kingdom to receive either conventional (103 patients) or experimental (104 patients) follow-up schedules. The experimental group received nurse-led reduced-frequency care. Quality of life was measured at baseline, at 1 year, and at 3 years.

Only 82.1% of participants completed questionnaires through year 3. No significant difference between standard and experimental groups was reported. Nearly all study participants (93%) reported being satisfied with their care, regardless of treatment group.

Overall compliance at year 1 did not differ between the conventional and experimental cohorts, respectively, (67% vs 69.9%). However, significantly more patients in the conventional group did not show up for scheduled appointments (22% vs 4.9%; P =.0006).


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Recurrence rates were similar between the two groups (15.5% [16 patients] vs 16.3% [17 patients]). Recurrences were mostly detected through self-examination (68.8% [11 patients] vs 70.6% [12 patients]).

A limitation of this study was that more patients dropped out than was anticipated, leading to a smaller number of patients (85) than was needed (89) for sufficient power.

The study authors concluded that these data were consistent with previously published data from the Netherlands, indicating that a less-intensive follow-up for patients treated for melanoma was both well accepted and did not negatively impact patient care. These results could cause significant preservation of national cancer service resources.

Reference

Moncrieff MD, Underwood B, Garioch JJ, et al. The MelFo study UK: effects of a reduced-frequency, stage-adjusted follow-up schedule for cutaneous melanoma 1B to 2C patients after 3-years [published online July 4, 2020]. Ann Surg Oncol. doi: 10.1245/s10434-020-08758-2.