Melanoma: Staging workup and followup recommendations

  • Baseline laboratory tests and imaging studies are generally not recommended in asymptomatic patients with newly diagnosed primary melanoma of any thickness. 
  • No clear data regarding follow-up interval exist, but at least annual history and physical examination with attention to skin and lymph nodes is recommended.
  • Regular clinical follow-up and interval patient self-examination of skin and regional lymph nodes are most important means of detecting recurrent disease or new primary melanoma; findings from history and physical examination should direct need for further studies to detect local, regional, and distant metastasis.
  • Surveillance laboratory tests and imaging studies in asymptomatic patients with melanoma have low yield for detection of metastatic disease and are associated with relatively high false-positive rates.

Strength of Recommendations: B Level of Evidence: II&III

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