ATLAS: A positive, high-yield review of patient symptoms most significantly associated with melanoma recurrence

J Am Acad Dermatol. 2024 Dec;91(6):1118-1124. doi: 10.1016/j.jaad.2024.07.1516. Epub 2024 Aug 26.

Abstract

Background: No standardized, evidence-based surveillance practices exist to guide and optimize recurrence detection in patients with cutaneous melanoma.

Objective: To determine the most high-yield positive review of systems for signaling recurrence in patients with cutaneous melanoma.

Methods: This retrospective cohort study assessed patients with a history of cutaneous melanoma and compared demographic and clinical characteristics, including a comprehensive review of systems, among those who experienced recurrence and those who did not.

Results: A high-yield positive review of systems associated with cutaneous melanoma recurrence can be remembered using the mnemonic "ATLAS": Appetite change, Tiredness, Lymph node enlargement, Abdominal pain, and Shortness of breath LIMITATIONS: Retrospective design, limited sample size, and variability in follow-up time between recurrent and nonrecurrent cohorts.

Conclusion: Any treating physician using this model may have a greater opportunity to detect recurrent cutaneous melanoma and improve outcomes while limiting cost and morbidity.

Keywords: dermatology; melanoma; oncology; recurrence; review of systems; surveillance.

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / etiology
  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Melanoma* / diagnosis
  • Melanoma* / pathology
  • Middle Aged
  • Neoplasm Recurrence, Local* / epidemiology
  • Retrospective Studies
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / pathology