Can late recurrence of melanoma be predicted at the time of primary treatment.

A cohort of patients followed post-operatively in the Department of Surgery at the University of Wales College of Medicine has been studied to determine whether there were specific factors associated with late recurrence of malignant melanoma. The incidence of late recurrence (beyond 5 years after primary treatment) was 6.1%, seen predominantly in females with lesions of intermediate thickness. No more specific criteria could be defined to identify this small group of melanoma patients, and which might be useful in selecting patients requiring longer term careful follow-up. Since most late recurrence is loco-regional, self-examination by the patient may be the best pragmatic approach to facilitate early diagnosis of recurrent disease without imposing a heavy burden on the follow-up services of the health system.