Melanoma follow-up care

In German-speaking countries, follow-up care of patients with malignant melanoma is carried out in a risk-adapted manner over a period of 10 years. In addition to regular total body examinations, further examinations such as ultrasound of draining lymph nodes, staging with CT or MRI scans and analysis of the tumor marker S100 are performed in a stage-dependent manner. Furthermore, patients should be instructed on how to perform self-examinations to detect a relapse or secondary melanomas. These self-examinations should be performed lifelong even after regular termination of follow-up care. Since 80% of all relapses occur within the first 3 years after initial diagnosis, there is consensus for intensive follow-up care during this period with the exception of stage IA melanomas, because there are no increased relapse rates in this stage in the first 3 years after initial diagnosis and the melanoma-specific survival rate is 95%. Examination intervals and diagnosis of metastases depend on the assumed risk of relapse at a given point in time. Intensified follow-up care in the first 3 years therefore includes examinations every 3 months; thereafter follow-up intervals can be extended to examinations every 6 months or once a year due to the lower risk for relapse.