. Author manuscript; available in PMC: 2023 Jan 1.

Published in final edited form as: Curr Probl Surg. 2021 Jul 7;59(1):101030. doi: 10.1016/j.cpsurg.2021.101030

Table 17.

Comparison between US, European, and Australian guidelines for follow-up in patients with resected cutaneous melanoma.

	National Comprehensive Cancer Network (NCCN)⁶³	European Society for Medical Oncology (ESMO)⁶⁶	Cancer Council Australia⁶⁷

History and physical examination	-Stage 0: annually -Stage IA-IIA: every 6–12 mo for 5 y, then annually -Stage IIB-IV: every 3–6 mo for 2 y, then every 3–12 mo for 3 y, then annually -Consider office-based imaging technologies in patients with numerous moles and/or atypical nevi	No consensus, but follow-up is generally recommended. Defer to national guidelines. Range of recommendations: -every 3 mo for 3 y, then every 6–12 mo -return visits as needed	-Stage I: annually for 10 y -Stage IIA: every 6 mo for 2 y, then annually for 8 y -Stage IIB-C: every 3–4 mo for 2 y, then every 6 mo for 1 y, then annually for 5 y -Stage IIIA-C: every 3 mo for 2 y, then every 6 mo for 1 y, then annually for 5 y -Those with risk factors (eg, family history, dysplastic nevus syndrome) may continue follow-up beyond 10 y
Imaging	Indications: -Equivocal lymph node examination -Positive SLN, but did not undergo CLND: every 4 mo for 2 y, then every 6 mo for 3 y -Stage IIB-IV disease: every 3–12 mo for 2 y, then every 6–12 mo for 3 y	-Not recommended for patients with thin melanomas -No consensus, but patients with high-risk disease may undergo serial imaging to aid early identification of recurrence, although no survival benefit	-Stage I-IIB: do not recommend routine imaging -Stage IIC-III: every 3–12 mo for 3 y -CT/MRI when indicated by clinical findings
Genetic testing	Consider additional genetic testing/genetic counselling if family history of multiple melanomas, or combination of melanoma, astrocytoma, pancreatic cancer	Test for actionable mutations at time of diagnosis No recommendations on further testing	Consider genetic testing for CDKN2A mutations/genetic counselling if family history of 3 or more melanomas in first- or second-degree relatives with high-risk features (eg, early onset, multiple primaries, history of pancreatic cancer)
Laboratory testing	Routine labs not recommended.	Routine labs not recommended	Routine labs not recommended.
Patient education	-Sun-safe behavior (avoiding exposure during peak hours, protective clothing, sunscreen) -Self-examination techniques	-Sun-safe behavior (avoid sunburns, avoid extended unprotected exposure) -Self-examinations for life -Educate regarding increased risk to family members	-Sun-safe behavior -Self-examination techniques

CLND, completion lymph node dissection; CT, computed tomography; MRI, magnetic resonance imaging; SLN, sentinel lymph node.