Risk factors associated with local and in-transit recurrence of cutaneous melanoma

Am J Surg. 2010 Dec;200(6):770-4; discussion 774-5. doi: 10.1016/j.amjsurg.2010.07.025.

Abstract

Background: Understanding the risk factors for local and in-transit recurrences (LR/ITR) may help facilitate methods of prevention, early detection, and treatment.

Methods: A retrospective review of a prospectively collected database was performed on patients diagnosed with single-lesion cutaneous melanoma. Clinical and pathologic characteristics of the tumors were evaluated.

Results: Of 225 patients, 10% had LR/ITR. Patients with LR/ITR were older (P = .0002), had thicker tumors (P = .018), and positive angiolymphatic invasion more frequently (P < .0001). An increased tumor mitotic rate (TMR) was more common in LR/ITRs (P = .051). On univariate logistic regression, age, thickness, TMR of 11/mm(2) or greater, and angiolymphatic invasion were all significant risk factors for LR/ITR. Multivariate logistic regression showed age, thickness, and angiolymphatic invasion were the only significant risk factors.

Conclusions: Older patients with thicker tumors and angiolymphatic invasion appear to be at higher risk for LR/ITR. Such patients warrant consideration of preventative strategies and should receive close clinical follow-up evaluation for early recurrence.

MeSH terms

  • Aged
  • Female
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Melanoma / pathology
  • Melanoma / secondary*
  • Melanoma / surgery
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Prognosis
  • Risk Factors
  • Sentinel Lymph Node Biopsy
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery