Recommendation ID

Follow-up surveillance imaging:- In people treated for high-risk stage II and III melanoma, does regular surveillance imaging improve melanoma-specific survival compared with routine clinical follow-up alone?
This should be investigated in a randomised controlled trial. Secondary outcomes should include time to recurrence, site of recurrence, proportion of people receiving active therapy at recurrence, cost effectiveness and quality of life.

Any explanatory notes
(if applicable)

Why this is important:- Until recently there have been no effective therapies for metastatic melanoma and no strong rationale for early detection of relapse through surveillance imaging. However, new, effective targeted treatments and immunotherapy agents are now available and further treatments are likely to become available in the near future. In particular, immunotherapy can offer long-term disease-free survival but takes a number of months to take effect. In this situation, early detection
of relapse may identify people likely to be fit enough to receive the treatment for long enough to benefit.
Although early detection of relapse through surveillance imaging might appear likely to improve outcomes, there is no evidence to confirm this. In addition, routine imaging has resource implications and involves more hospital visits and increased radiation exposure for the person.

Source guidance details

Comes from guidance
Melanoma: assessment and management
Date issued
July 2015

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No