LAUSR

low risk) was associated with significantly increased diseasefree survival of 97% vs. 87% for patients with melanomas in which AMBLor was lost (P = 0 01; hazard ratio 0 20, 95% confidence interval 0 09–0 42), and with a negative predictive value of 97 1%. A budget impact model was subsequently constructed using parameters from National Health Service reference costs and a freedom of information request, involving 75 trusts and published papers. The model assumed patients with AJCC stage IA AMBLor low-risk melanoma are steppeddown from the NG14 National Institute for Health and Care Excellence melanoma guidelines follow-up regimen of four in 1 year to one at the end of the first year and with AJCC stage IB–IIB AMBLor low-risk melanomas reduced from 16 visits over 5 years to four annual reviews. Attendant reductions in computed tomography scans, SLNB and complications were modelled with pathology costs demonstrating an average saving of £175 18 per patient. Collectively, these data suggest AMBLor as a marker to identify a genuinely low-risk subsets of patients with AJCC stage I/II melanomas. Furthermore, use of AMBLor may serve as a means of stratifying patients for reduced follow-up and/or SLNB, with the potential for significant savings on healthcare resources.