[The value of radiological follow-up for stage III melanoma].
BACKGROUND
The modalities of follow-up (frequency of consultations and interest of repeated radiological examinations) of patients presenting with glandular metastases of melanoma (stage III of the AJCC classification) have not reached a consensus.


METHODS
Since 1995, we have proposed clinical follow-up every two months and radiological controls with a thoracic-abdominal-pelvic scan every 4 months, to patients at high risk of relapse for the early screening of an infra-clinical relapse.


RESULTS
The median follow-up was of 16 months (range: 1 to 82 months). Eight patients out of 24 (33 p. 100) followed-up in this manner, had asymptomatic metastases discovered by the radiological examinations. Among these 8 patients, three presented with a an operable, single, metastatic localization and two patients underwent surgery. One patient relapsed 3 months later, the other was still alive without relapse 24 months later.


CONCLUSIONS
Surgery remains the treatment of choice for all stages of melanoma. In the absence of clearly effective treatment of metastatic melanoma, the early discovery of an infra-clinical metastatic relapse presents two major advantages. The first is the discovery of a single, operable metastasis, as was the case in two of the patients out of 24. The second is to be able to suspend an eventual adjuvant therapy with interferon alpha, as soon as a relapse has been discovered.
Service de Dermatologie 2, Hôpital Saint-Louis, 1, avenue Claude Vellefaux, 75010 Paris. delphine.karob@sls.ap-hop-paris.fr
D
D
Kerob
M
M
Baccard
A
A
Dupuy
L
L
Ollivaud
N
N
Basset-Seguin
M
M
Rybojad
N E
NE
Schartz
A M
AM
Zagdanski
L
L
Dubertret
P
P
Morel
C
C
Lebbé
L
L
Olliveau
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D011859:Radiography; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D013997:Time Factors