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November 1987

Prognosis for Recurrent Stage I Malignant Melanoma

Author Affiliations

From the Departments of Surgery (Drs Reintgen and Seigler) Bio-statistics (Dr Tso), and Pathology (Dr Vollmer), Duke University Medical Center, Durham, NC. Dr Reintgen is a recipient of the Armand Hammer Travel Award for the 1987 meeting.

Arch Surg. 1987;122(11):1338-1342. doi:10.1001/archsurg.1987.01400230126022

• The outcome of patients with stage I malignant melanoma has been well assessed in terms of prognostic factors and their effect on survival; however, little is known of the recurrence patterns of cutaneous melanoma or the survival of these patients subsequent to recurrence. A retrospective, computer-aided chart review identified 4185 patients with melanoma who had stage I disease clinically. During a follow-up period of one to 14 years, 35.9% suffered a recurrence. Melanoma of the trunk (37.8%) and head and neck area (46.1%) had an increased incidence of recurrent metastases compared with melanoma of the extremities (29.8%). Local regional metastases accounted for 62.5%, 77.3%, and 85.6% of the recurrences in the head and neck, trunk, and extremity primary sites, respectively, with 65% of the relapses occurring within the first three years. Actuarial five-year survival rates of patients who had recurrent disease were significantly decreased compared with those of patients who had no evidence of metastases during their clinical course. A multivariate analysis was performed to estimate the survival of patients after recurrence. One may use this mathematical model to predict the outcome of individual patients after recurrence and provide a more rationally based prognosis for them and their families.

(Arch Surg 1987;122:1338-1342)