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Recurrence behavior in early-stage cutaneous melanoma: pattern, timing, survival, and influencing factors

Tas, Faruk; Erturk, Kayhan

doi: 10.1097/CMR.0000000000000332
ORIGINAL ARTICLES: Clinical research

Nearly one-third of all melanoma patients will experience disease recurrence and the majority of the relapses eventually develop metastatic disease as a consequence of disease progression in the early-stage melanoma patients. As very few number of studies have investigated the natural recurrence history of early-stage cutaneous melanoma at the first relapse, we analyzed the time until recurrence along with the patterns and outcomes of the relapses in this retrospective study. A total of 332 patients who were initially diagnosed with nonmetastatic melanoma and developed recurrence during the disease course and/or follow-up were included in the analysis. Locoregional relapse alone defined regional lymph node metastases, distant skin, subcutaneous, and satellite/in-transit metastases. Nearly half of the primary recurrences were locoregional metastasis alone (50.6%), followed by mixed locoregional and distant metastases (25.9%), and distant metastases alone (23.5%). In terms of distant metastasis, the lung was the most frequently affected site (30.7%), followed by bone (15.7%), liver (13.9%), and brain (10.8%). The time intervals for each of the recurrence patterns and distant metastasis sites were identical and nearly 16 months. Nearly two-thirds of the relapses occurred within the first 2 years of diagnosis. A significant survival advantage was observed in locoregional relapse alone compared with other relapse patterns (P<0.0001). In conclusion, about half of the melanoma patients developed locoregional relapse alone and it was found to be associated with a favorable prognosis for outcome. Because nearly two-thirds of the relapses occurred within the first 2 years of diagnosis, we suggest that all early-stage melanoma patients should be kept under a strict, thorough, and close follow-up program for at least 2 years following the diagnosis.

Department of Medical Oncology, Institute of Oncology, University of Istanbul, Istanbul, Turkey

Correspondence to Faruk Tas, MD, Department of Medical Oncology, Institute of Oncology, Istanbul University, Capa, 34390 Istanbul, Turkey Tel/fax: +90 212 534 8078; e-mail:

Received November 14, 2016

Accepted December 28, 2016

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