Sümeyre Seda Ertekin, Sebastian Podlipnik, Constanza Riquelme-Mc Loughlin, Alicia Barreiro-Capurro, Ana Arance, Cristina Carrera, Josep Malvehy, Susana Puig
DOI: 10.2340/00015555-3832

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.

This study investigated the role of initial American Joint Committee on Cancer stage on the pattern and timing of first disease recurrence in a large cohort of patients with cutaneous melanoma. Earlier stage at initial diagnosis was associated with a higher proportion of locoregional metastasis and a longer time to first disease recurrence compared with more advanced stages. As stage I patients develop distant metastasis especially late, they may require longer follow-up periods with adequate protocols.

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