The following is a summary of “Timing and necessity of staging imaging in clinical stage II cutaneous melanoma: Cost-effectiveness and clinical decision analysis,” published in the JANUARY 2023 issue of Surgery by Khan, et al.

Although not recommended by National Comprehensive Cancer Network (NCCN) recommendations for clinical stage II melanoma, preoperative imaging was nonetheless often used in clinical practice.

A retrospective analysis was done by researchers on patients who presented with stage II cutaneous melanoma between 2007 and 2019. To comprehend appropriate practice patterns in handling stage II melanoma, a clinical decision analysis using cost data was created, utilizing pre-versus selective post-operative imaging as the initial decision node.

A total of 143 of the 277 included individuals (or 49.5%) had preoperative imaging. The therapy was altered in one patient (0.4%) to avoid surgery. New imaging abnormalities were seen in 16 individuals (5.8%). With a savings of $1,677 per patient, upfront surgery combined with selected postoperative imaging was found to be a more cost-effective technique.

In conclusion, preoperative imaging is a high-risk, expensive treatment option for individuals with clinical stage II melanoma with little bearing on the choice to proceed with surgical care.

Reference: americanjournalofsurgery.com/article/S0002-9610(22)00652-3/fulltext