Wevers K P, Hoekstra-Weebers J E H M, Speijers M J, Bergman W, Gruis N A, Hoekstra H J
Division of Surgical Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
Wenckebach Institute, University of Groningen, University Medical Center Groningen, The Netherlands; Comprehensive Cancer Center Netherlands, Location Groningen, The Netherlands.
Eur J Surg Oncol. 2014 Oct;40(10):1276-83. doi: 10.1016/j.ejso.2014.02.240. Epub 2014 Mar 4.
The purpose, frequency and content of follow-up (FU) visits have been widely debated for all common malignancies, including melanoma. The aim was to gain insight into Dutch medical specialists' opinions on melanoma FU and to assess their views on sentinel lymph node biopsy (SLNB).
All members of the Dutch Society of Surgical Oncology and the Dutch Society of Dermatology and Venereology were invited to complete a web-based questionnaire, consisting of 25 questions addressing the following topics: 1) respondent characteristics, 2) knowledge of national melanoma guideline, 3) opinions on melanoma FU, and 4) view on the significance of SLNB.
A total of 378 respondents (response = 37%) started the survey, including 173 surgeons (46%) and 205 dermatologists (54%). Of these, 97% and 92% agreed that the purpose of FU is detection of local recurrence and second primary, respectively. Concerning frequency of FU in the first 10 years after diagnosis, 42% preferred a less frequent FU than indicated by the current guideline, while 4% preferred more frequent FU. Overall, twenty-five percent agreed that the standard diagnostics of cutaneous melanoma should include a SLNB, the percentage was highest amongst surgical residents (44%).
The majority of specialists consider melanoma FU to be primarily an instrument to detect recurrences and secondary primaries. The frequency of FU, as prescribed by the current guideline, could be reduced according to 42%. The importance of SLNB seems to be insufficiently addressed in the Dutch guideline and by Dutch medical specialists despite its role in the AJCC staging system.
包括黑色素瘤在内的所有常见恶性肿瘤，其随访（FU）的目的、频率和内容一直存在广泛争议。目的是深入了解荷兰医学专家对黑色素瘤随访的看法，并评估他们对前哨淋巴结活检（SLNB）的观点。
邀请荷兰外科肿瘤学会和荷兰皮肤病与性病学会的所有成员完成一份基于网络的问卷，该问卷由25个问题组成，涉及以下主题：1）受访者特征，2）对国家黑色素瘤指南的了解，3）对黑色素瘤随访的看法，4）对前哨淋巴结活检意义的观点。
共有378名受访者（回复率 = 37%）开始参与调查，其中包括173名外科医生（46%）和205名皮肤科医生（54%）。其中，分别有97%和92%的人同意随访的目的是检测局部复发和第二原发性肿瘤。关于诊断后前10年的随访频率，42%的人倾向于采用比当前指南规定频率更低的随访，而4%的人倾向于更频繁的随访。总体而言，25%的人同意皮肤黑色素瘤的标准诊断应包括前哨淋巴结活检，这一比例在外科住院医师中最高（44%）。
大多数专家认为黑色素瘤随访主要是一种检测复发和第二原发性肿瘤的手段。根据42%的受访者观点，当前指南规定的随访频率可以降低。尽管前哨淋巴结活检在AJCC分期系统中发挥作用，但荷兰指南和荷兰医学专家似乎并未充分重视其重要性。
