Patterns in progression from early-stage melanoma to late-stage melanoma: implications for survivorship follow-up.

Aim: This study determined the characteristics of patients with early-stage melanoma (IA-IIA) who later had stage IV recurrence.Patients & methods: We retrospectively examined 880 melanoma patients and identified those who progressed to stage IV disease from an initial early-stage (n = 50).Results: We observed a median latent period of 4 years between early-stage diagnosis and metastatic disease. More patients (54%) developed metastatic disease 4 years or later from the initial diagnosis. 34% had regular dermatology appointments, and 30% had regular oncology follow-up. Lung and brain were the most common metastatic sites.Conclusion: Long term monitoring beyond 4 years and a low threshold for performing symptom-guided imaging, particularly if pulmonary or neurologic symptoms occur, may be prudent after early-stage melanoma diagnosis.