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Revised 22 Feb. 2011​​

​In the follow-up history special attention is paid to possible local, regional or distant recurrences, development of new or unusual pigmented lesions especially where there are changes in shape, colour, elevation, irregular pigmentation, pruritus, ulceration or bleeding. Areas of special interest on physical examination include the primary site, possible in transit metastases, regional lymph nodes and sites where distant metastases tend to appear (skin, lymph nodes, lung, liver, brain). The interval of follow-up surveillance varies depending on individual tumour characteristics:

1) Stage I   ​

First and Second Years
History and physical examination every 6 months. At each visit, particular attention should be directed to the skin and lymph nodes. 

Subsequent Years
Annual history and physical examination, including a complete skin assessment. Patients with low risk melanomas may have late recurrences (>10 years after treatment). Also, melanoma patients have an approximate 5% risk of developing a second melanoma. Therefore, melanoma surveillance should be life long.

Patients with a history of atypical mole or a strong family history of melanoma may require more frequent follow up.

2) Stage II, III  ​

First Two Years
  • History and phy​sical examination every 3 to 6 months
Third and Fourth Years
  • History and physical examination every 6 months
Subsequent to Fourth Year
  • Annual history and physical examination

3) Meta​​static Disease

Follow up as clinically indicated.

SOURCE: Follow-up ( )
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