PDF(Pubmed)
Abstract：
BACKGROUND: Cutaneous melanoma accounts for more than 70% of all skin cancer deaths. Follow-up surveillance is an integral part of melanoma patient care, to facilitate early detection of recurrences and subsequent primary melanomas. The purpose of this scoping review is to provide an overview of recently published melanoma surveillance guidelines from regional and national melanoma working groups.
METHODS: A systematic search for relevant studies in MEDLINE and Embase was conducted in September 2022 and was limited to publications from 2010 or later.
RESULTS: A total of 1047 articles were retrieved, and after abstract and full text review, 26 articles from 19 different organizations met inclusion criteria. Life-long annual skin surveillance with a physician was recommended by 53% (9/17) of guidelines. Routine laboratory investigations were recommended by 7/19 guidelines. Regional lymph node ultrasound was recommended by 9/16 guidelines, most often in stage IB or higher, and was optional in 7/16 for patients who met specific criteria. Surveillance with PET-CT or CT and MRI was recommended by 15 and 11 guidelines, respectively, most commonly in stage IIC or higher, with a variable frequency and total duration. Five out of 9 guidelines indicated a preference for skin surveillance to be completed with a dermatologist.
CONCLUSIONS: Guidelines were highly variable for many aspects of melanoma surveillance, which may be partly attributed to regional differences in healthcare workforce distribution and availability of imaging technologies. Further high-level studies are recommended to provide more evidence on the most effective clinical and imaging follow-up surveillance protocols.
METHODS: A systematic search for relevant studies in MEDLINE and Embase was conducted in September 2022 and was limited to publications from 2010 or later.
RESULTS: A total of 1047 articles were retrieved, and after abstract and full text review, 26 articles from 19 different organizations met inclusion criteria. Life-long annual skin surveillance with a physician was recommended by 53% (9/17) of guidelines. Routine laboratory investigations were recommended by 7/19 guidelines. Regional lymph node ultrasound was recommended by 9/16 guidelines, most often in stage IB or higher, and was optional in 7/16 for patients who met specific criteria. Surveillance with PET-CT or CT and MRI was recommended by 15 and 11 guidelines, respectively, most commonly in stage IIC or higher, with a variable frequency and total duration. Five out of 9 guidelines indicated a preference for skin surveillance to be completed with a dermatologist.
CONCLUSIONS: Guidelines were highly variable for many aspects of melanoma surveillance, which may be partly attributed to regional differences in healthcare workforce distribution and availability of imaging technologies. Further high-level studies are recommended to provide more evidence on the most effective clinical and imaging follow-up surveillance protocols.
摘要：
背景：皮肤黑色素瘤占所有皮肤癌死亡的70％以上。随访监测是黑色素瘤患者护理不可或缺的一部分，有助于早期发现复发和随后的原发性黑色素瘤。本范围审查的目的是提供区域和国家黑色素瘤工作组最近发布的黑色素瘤监测指南的概述。
方法：2022年9月对MEDLINE和Embase的相关研究进行了系统搜索，仅限于2010年或以后的出版物。
结果：共检索到1047篇文章，经过摘要和全文审查，来自19个不同组织的26篇文章符合纳入标准。53％（9/17）的指南建议与医生进行终身年度皮肤监测。7/19指南建议进行常规实验室调查。9/16指南推荐区域淋巴结超声，最常见的是在阶段IB或更高，对于符合特定标准的患者，在7/16中是可选的。15和11个指南建议使用PET-CT或CT和MRI进行监测，分别,最常见的是阶段IIC或更高，具有可变的频率和总持续时间。9个指南中有5个表示倾向于由皮肤科医生完成皮肤监测。
结论：指南对于黑色素瘤监测的许多方面都是高度可变的，这可能部分归因于医疗劳动力分布和成像技术可用性的地区差异。建议进一步的高水平研究为最有效的临床和影像学随访监测方案提供更多证据。
方法：2022年9月对MEDLINE和Embase的相关研究进行了系统搜索，仅限于2010年或以后的出版物。
结果：共检索到1047篇文章，经过摘要和全文审查，来自19个不同组织的26篇文章符合纳入标准。53％（9/17）的指南建议与医生进行终身年度皮肤监测。7/19指南建议进行常规实验室调查。9/16指南推荐区域淋巴结超声，最常见的是在阶段IB或更高，对于符合特定标准的患者，在7/16中是可选的。15和11个指南建议使用PET-CT或CT和MRI进行监测，分别,最常见的是阶段IIC或更高，具有可变的频率和总持续时间。9个指南中有5个表示倾向于由皮肤科医生完成皮肤监测。
结论：指南对于黑色素瘤监测的许多方面都是高度可变的，这可能部分归因于医疗劳动力分布和成像技术可用性的地区差异。建议进一步的高水平研究为最有效的临床和影像学随访监测方案提供更多证据。
