Annals of Surgical Oncology Cite Track
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-007-9717-9
Annals of Surgical Oncology 15:1476-1484 (2008)
© 2008 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Francken, A. B.
Right arrow Articles by Thompson, J. F.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Francken, A. B.
Right arrow Articles by Thompson, J. F.

Original Article

Prognosis and Determinants of Outcome Following Locoregional or Distant Recurrence in Patients with Cutaneous Melanoma

Anne Brecht Francken, MD1,2, Neil A. Accortt, PhD3, Helen M. Shaw, PhD1,4, Martin Wiener, MBChB1, Seng-jaw Soong, PhD3, Harald J. Hoekstra, MD, PhD2 and John F. Thompson, MD, FRACS, FACS1,4

1 Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
2 Division of Surgical Oncology, Groningen University Medical Center and University of Groningen, Groningen, The Netherlands
3 Biostatistics and Bioinformatics Unit, Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
4 Discipline of Surgery, The University of Sydney, Sydney, New South Wales, Australia

Correspondence: Address correspondence and reprint requests to: John F. Thompson, MD, FRACS, FACS; E-mail: john.thompson{at}smu.org.au

Objective: Information on prognosis for patients with cutaneous melanoma after locoregional or distant recurrence is sparse and controversial. The aim of this study was to analyze factors influencing outcome after the development of a first relapse.

Methods: Information was extracted from the Sydney Melanoma Unit database for 873 melanoma patients with American Joint Committee on Cancer (AJCC) Stage I and II disease treated between 1960 and 2002 who relapsed following treatment of their primary melanoma. Clinical and pathologic factors predicting survival were analyzed using the Cox proportional hazards regression model.

Results: Initial presentation of recurrence was local: 95 patients (10.9%), in transit: 86 patients (9.9%), regional lymph node: 300 patients (34.4%), and distant: 392 patients (44.9%). Independent prognostic factors for survival of the 481 patients with only locoregional recurrence were type of recurrence, primary tumor ulceration, and patient age. Predictors for longer survival in the 392 patients with distant metastasis at the time of first presentation with recurrence were lung vs other sites and diagnosis of relapse after 1990 compared with diagnosis before 1980.

Conclusions: The type of recurrence is the most important prognostic factor in melanoma patients who relapse. Primary tumor ulceration is the most important pathologic predictor. The results of this study suggest that management of distant metastases may have improved over the last 25 years, but many confounders and improved staging techniques make assessment of this unreliable.

Key Words: Melanoma • Recurrence • Metastases • Prognostic factors • Survival






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the Society of Surgical Oncology.