Indian Journal of Dermatology
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DERMATOLOGY IN INTERNAL MEDICINE
Year : 2014  |  Volume : 59  |  Issue : 3  |  Page : 241-246

Predictive factors for loco regional recurrence and distant metastasis following primary surgical treatment of cutaneous melanoma


Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India

Correspondence Address:
Dr. Mahesh Kalloli
Plot No. 13, Door No 173/A, VidyaNagar, Gokak - 590 016, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.131383

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Background: Cutaneous melanoma (CM) has a high propensity for regional and systemic spread. This is one of the largest series of CM reported from India. Aims: To predict factors for loco regional recurrence (LRR) and distant metastasis in patients with CM primarily treated with surgery. Study Design: Retrospective analysis of patient database at a tertiary care cancer center with evaluation of factors for LRR and distant metastasis for CM. Materials and Methods: Data from 68 patients treated for CM between January 2006 and December 2010 were reviewed. Data recorded included age, sex, symptoms, investigations, treatment given, histopathology, recurrence and follow-up. Patient factors, tumor factors, pathologic variables, and adjuvant treatment were investigated as predictors' of LRR and distant metastasis. Results: Mean age of patients was 54 years. Melanoma was more common in males (44). Tumor thickness > 4 mm was found in 43 patients. Lymph node involvement was found in 43 patients. Adjuvant radiotherapy was given in seven patients. At mean follow-up of 16.5 months, LRR was seen in 34 patients and distant metastasis in 28 patients. LRR and distant metastasis were more commonly found in females, age > 40 years, Clark's level IV and V, Breslow's depth > 4 mm, patients with lymph node involvement and extra-capsular spread. Conclusion: The age, sex, site, thickness of lesion, involvement of lymph node, and extra-capsular spread were important factors in predicting LRR and distant metastasis. Distant metastasis was also more commonly found in patients with LRR.


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