Cutaneous melanoma: Medical specialists' opinions on follow-up and sentinel lymph node biopsy

• Published in: European journal of surgical oncology 2014-10, Vol.40 (10), p.1276-1283
• Main Authors: Wevers, K.P, Hoekstra-Weebers, J.E.H.M, Speijers, M.J, Bergman, W, Gruis, N.A, Hoekstra, H.J
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Dermatology; Disease Management; Follow-up; General Surgery; Hematology, Oncology and Palliative Medicine; Humans; Melanoma; Melanoma - therapy; Neoplasm Recurrence, Local - diagnosis; Neoplasms, Second Primary - diagnosis; Netherlands; Practice Guidelines as Topic; Professionals; Questionnaire; Sentinel Lymph Node Biopsy; Sentinel node; Skin Neoplasms - therapy; Surgery; Survey; Surveys and Questionnaires
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2014.02.240

Abstract Background 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). Methods 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. Results 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%). Conclusion 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.