Utility or Futility — Chest X-Rays for Melanoma Surveillance

Routine chest radiography conveys no benefit.

The National Comprehensive Cancer Network is one of several medical bodies to have wrestled with the utility of chest radiography (CXR) in postmelanoma surveillance. Although no trials have shown a benefit from annual CXRs, some physicians routinely order them, perhaps to assuage patient anxiety. Because isolated pulmonary metastases can be resected and thus might improve survival, some surgeons have also advocated for routine yearly CXRs. To determine the clinical efficacy of routine CXR surveillance of recurrence in melanoma, investigators reviewed data on 1235 patients followed for a median of 74 months.

A total of 210 patients (17.0%) had a recurrence, most commonly local or in-transit. Of the 4218 CXRs performed in all 1235 patients, 88…

Reviewing Author

Hensin Tsao, MD, PhD

Disclosures

Consultant / advisory board Lubax; WorldCare Clinical

EquityLubax

Grant / Research support NIH; Department of Defense; American Skin Association; Piramal

Editorial boardsBritish Journal of Dermatology; Journal of the American Academy of Dermatology; Journal of Investigative Dermatology

Leadership positions in professional societies American Academy of Dermatology (Chair, Skin Cancer and Melanoma Committee); American Board of Dermatology (Director)