Abstract
Melanoma is increasing in the Netherlands and diagnosis is made at an increasingly earlier stage, resulting in a more favorable prognosis. Currently, 5-year survival rate is 92%.
Melanoma diagnostics, treatment and follow-up can further increase this percentage. PhD student Eric Deckers therefore conducted research, specifically into the sentinel-node procedure (SLNB), the use of tumor markers and nuclear imaging, the frequency of follow-up and the effect of obesity on disease progression and survival in melanoma.
The SLNB can determine metastases in a minimally invasive manner, so that the correct melanoma treatment can be performed. The SLNB is currently only performed at 65% for eligible patients in the Netherlands. A further implementation up to 80 (breast cancer) seems necessary.
Follow-up checks of high-risk melanoma patients without complaints, increased blood levels of the tumor markers S-100B and LDH may be an indication for performing a PET/CT scan to detect early metastases and initiate treatment.
A RCT showed that a less frequent follow-up than recommended in the current guideline for SLNB-staged melanoma patients 3-years after diagnosis, is associated with fewer stress symptoms, comparable anxiety and quality of life. Less frequent follow-up is safe in the sense of detecting recurrences, survival and it reduces the follow-up costs with 39%.
Obesity does is not associated with recurrence-free and overall-survival. A multi-center study is needed to confirm or invalidate this result.
The improvements in melanoma diagnostics with SLNB, tumor markers, PET/CT and stage-based follow-up schedules contribute to better, cost-effective melanoma treatment and quality of life.
Melanoma diagnostics, treatment and follow-up can further increase this percentage. PhD student Eric Deckers therefore conducted research, specifically into the sentinel-node procedure (SLNB), the use of tumor markers and nuclear imaging, the frequency of follow-up and the effect of obesity on disease progression and survival in melanoma.
The SLNB can determine metastases in a minimally invasive manner, so that the correct melanoma treatment can be performed. The SLNB is currently only performed at 65% for eligible patients in the Netherlands. A further implementation up to 80 (breast cancer) seems necessary.
Follow-up checks of high-risk melanoma patients without complaints, increased blood levels of the tumor markers S-100B and LDH may be an indication for performing a PET/CT scan to detect early metastases and initiate treatment.
A RCT showed that a less frequent follow-up than recommended in the current guideline for SLNB-staged melanoma patients 3-years after diagnosis, is associated with fewer stress symptoms, comparable anxiety and quality of life. Less frequent follow-up is safe in the sense of detecting recurrences, survival and it reduces the follow-up costs with 39%.
Obesity does is not associated with recurrence-free and overall-survival. A multi-center study is needed to confirm or invalidate this result.
The improvements in melanoma diagnostics with SLNB, tumor markers, PET/CT and stage-based follow-up schedules contribute to better, cost-effective melanoma treatment and quality of life.
| Original language | English |
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| Qualification | Doctor of Philosophy |
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| Supervisors/Advisors |
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| Award date | 26-Oct-2020 |
| Place of Publication | [Groningen] |
| Publisher | |
| Print ISBNs | 978-94-6402-178-3 |
| Electronic ISBNs | 978-94-6402-203-2 |
| DOIs | |
| Publication status | Published - 2020 |