Fast Five Quiz: How Much Do You Know About Melanomas?

William James, MD

Disclosures

February 18, 2020

Although abnormal laboratory test results are rarely the sole indicator of metastatic disease, serum LDH levels are included in the AJCC melanoma staging guidelines for the classification of stage IV (distant) disease. In the eighth edition of the AJCC guidelines, LDH levels are used to determine M1a(0), M1a(1), M1b, M1b(0), and M1b(1) categories.

Current NCCN guidelines do not recommend surveillance (follow-up) laboratory or imaging studies for patients with stage IA, IB, and IIA melanoma (ie, tumors ≤ 4 mm depth) without evidence of disease (NED). Imaging studies (chest radiography, CT, and/or PET-CT) should be obtained as clinically indicated for confirmation of suspected metastasis or to delineate the extent of disease and may be considered to screen for recurrent/metastatic disease in some patients with stage IIB to IV disease. Routine laboratory or radiologic imaging in asymptomatic melanoma patients of any stage is not recommended after 3-5 years of follow-up.

Guidelines established by the American Academy of Dermatology in 2019 also do not recommend baseline imaging or laboratory tests in asymptomatic patients with any stage of cutaneous melanoma (IA–IIC).

For more on the workup of cutaneous melanoma, read here.

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