Initial Stage of Cutaneous Primary Melanoma Plays a Key Role in the Pattern and Timing of Disease Recurrence

Acta Derm Venereol. 2021 Jul 15;101(7):adv00502. doi: 10.2340/00015555-3832.

Abstract

Given recent developments in the treatment of metastatic melanoma, early detection of disease recurrence is crucial. The aim of this single-centre retrospective cohort study was to investigate the impact of the initial stage of primary melanoma on the pattern and timing of disease recurrence and post-recurrence survival. Patients diagnosed with cutaneous melanoma with initial stage IA-IIID, between January 1996 and December 2018 and who developed disease recurrence until May 2019 were included (n = 784). Earlier stage at diagnosis was associated with a higher proportion of locoregional and a lower proportion of distant metastasis (p = 0.01). The median time to first metastasis decreased with the more advanced stages at initial diagnosis: 3.32 years (interquartile range (IQR) 1.72-6.14 years) for stage I, 1.85 years (IQR 0.99-3.78 years) for stage II and 1.19 years (IQR 0.70-2.42 years) for stage III disease (p < 0.001). These findings add evidence that American Joint Committee on Cancer stages at initial diagnosis of melanoma play a key role in the pattern and timing of disease recurrence and may be helpful to improve surveillance strategies in the follow-up of patients with melanoma.

Keywords: cutaneous malignant; disease progression; follow-up studies; metastasis, survival; recurrence; melanoma.

MeSH terms

  • Humans
  • Melanoma* / pathology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / therapy