title: Late recurrence of localized cutaneous melanoma: its influence on follow-up policy.
abstract: This paper reports 11 cases of recurrence 10 years or more after primary treatment of clinically local cutaneous melanoma at the Peter MacCallum Cancer Institute. Using the product-limit method for estimating recurrence-free survival, two late recurrence rates have been calculated. The estimated late recurrence rate among all treated patients is 5 percent (95 percent confidence interval: 2 to 8 percent), and the estimated late recurrence rate for the group who survived the first 10 years without recurrence is 7 percent (95 confidence interval: 3 to 11 percent). No prognostic factors were found that could identify a patient subgroup significantly at risk of late recurrence. Recurrence-free survival curves show that most recurrences have presented by the end of 6 years, but later recurrences are seen, the latest in this series being 18.2 years following treatment. While patients probably do not require long-term follow-up in specialist clinics provided they are adequately educated in the nature of their disease, this paper shows the value of long-term statistical surveillance.
authors.affiliation: Skin Unit and Statistical Centre, Peter MacCallum Cancer Institute, Melbourne, Australia.
authors.forename: L
authors.initials: L
authors.lastname: McEwan
authors.forename: J G
authors.initials: JG
authors.lastname: Smith
authors.forename: J P
authors.initials: JP
authors.lastname: Matthews
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology; D015996:Survival Rate; D013997:Time Factors