Follow-up of patients with a thin melanoma.

Background: The aim of this study was to determine the value of follow-up in two subgroups of patients with a thin melanoma less than 0·76 mm and 0·76–1·5 mm thick. Methods: The study group comprised all patients presenting to the Cardiff Melanoma Clinic from its introduction in 1976 to the end of 1994. All patients attend follow-up according to a strict protocol, determined by the thickness of the original melanoma (less than 0·76 mm, annually; more than 0·76 mm, every 2 months for 2 years, 3 monthly for 2 years, 4 monthly for 1 year and then annually). Results: In total there were 306 patients with a thin melanoma: 178 with a melanoma thinner than 0·76 mm (group 1) and 128 with a melanoma of 0·76–1·5 mm (group 2). The groups were well matched for age (mean 50·6 (range 8–87) versus 50·6 (range 19–89) years respectively) and length of follow-up (mean 88·6 (range 4–296) versus 80·4 (range 2–296) months). Four patients (2·2 per cent) developed recurrence in group 1 and 16 (12·5 per cent) in group 2. The mean time to recurrence was 84·5 (range 49–143) months in group 1 and 45·3 (range 2–74) months in group 2. All patients in group 1 and 14 of 16 in group 2 died from recurrent disease. Conclusion: Follow-up of patients with a melanoma less than 0·76 mm thick is not worthwhile. All recurrences would have been detected by annual review for 7 years in patients with melanomas between 0·76 and 1·5 mm thick. © 1999 British Journal of Surgery Society Ltd