Is Patient-Led Surveillance Feasible After Localized Melanoma?

Patient-led surveillance correlated with increased skin self-examination frequency, had no adverse impact on psychological outcomes

By Dermsquared Editorial Team | November 24, 2021

Patient-led surveillance is safe and feasible after treatment of localized melanoma, according to a study published online Nov. 24 in JAMA Dermatology .

Deonna M. Ackermann, M.P.H., from the School of Public Health at the University of Sydney, and colleagues conducted a pilot for a randomized clinical trial involving 100 patients who had been treated for localized melanoma, owned a smartphone, had a partner to assist with skin self-examination (SSE), and had been attending scheduled follow-up visits. Participants were randomly assigned to six months of patient-led surveillance or clinician-led surveillance (49 and 51 patients, respectively).

The researchers found that patient-led surveillance correlated with increased SSE frequency and thoroughness compared with clinician-led surveillance (odds ratios, 3.5 [95 percent confidence interval (CI), 0.9 to 14.0] and 2.2 [95 percent CI, 0.8 to 5.7], respectively), no detectable adverse impact on psychological outcomes (fear of cancer recurrence subscale score: mean difference, –1.3; 95 percent CI, –3.1 to 0.5), and increased clinic visits (risk ratio, 1.5; 95 percent CI, 1.1 to 2.1), skin lesion excisions (risk ratio, 1.1; 95 percent CI, 0.6 to 2.0), and subsequent melanoma diagnoses (risk difference, 10 percent; 95 percent CI, –2 to 23 percent). Eight participants in the intervention group were diagnosed with new primary melanomas and one local recurrence, including five ahead of routinely scheduled visits; in the control group, three were diagnosed, none of which were ahead of routinely scheduled visits.

"This pilot randomized clinical trial found that patient-led surveillance of melanoma appears to be safe, feasible, and acceptable," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

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