TOPLINE: 

A study of 1092 patients with stage IA to IIC melanomas identified several factors associated with recurrence, including tumor location on the scalp or neck, thickness, ulceration, neurotropism, lymphovascular invasion, and presence of mitoses.

METHODOLOGY:

• Researchers conducted a retrospective cohort study of 1092 patients (median age, 60 years; 57% men, 96.7% White) diagnosed with stage IA to IIC melanomas from 2010 to 2017 at the University of California, San Francisco, with data analyzed from January 1 to March 15, 2025.
• The median tumor thickness was 1.1 mm while the mean thickness was 1.9 mm.
• Patients with recurrent, metastatic, noncutaneous, duplicate, or multiple melanomas diagnosed during the study period were excluded.
• The primary outcomes were presence of melanoma recurrence and time to recurrence, with local, regional, and distant recurrences recorded. The median follow-up was 7.2 years.

TAKEAWAY:

• Overall, 178 melanomas (16.3%) recurred, with a median time to recurrence of 2 years. Recurrence rates increased with increasing stage: 4.3% for stage IA, 15.1% for stage IB, 28.3% for stage IIA, 37.2% for stage IIB, and 36.4% for stage IIC tumors.
• Distant recurrences were most common (47.8%), followed by regional (33.1%) and local (19.1%).
• Ulceration (hazard ratio [HR], 3.48; P < .001), thickness (HR, 1.09; P < .001), and tumor location on the scalp or neck (HR, 3.22; P < .001) or face (HR, 2.14; P = .003) compared with the arms were associated with time to recurrence in the multivariate analysis.
• Neurotropism (HR, 1.96; P = .04), lymphovascular invasion (HR, 2.52; P = .049), and presence of mitoses (HR, 3.93; P < .001) were also significantly associated with time to recurrence in multivariable models.

IN PRACTICE:

"In this study, for stage IA to IIC melanomas, several clinicopathologic variables (i.e., thickness, ulceration, tumor site, neurotropism, lymphovascular invasion, mitoses) are associated with time to melanoma recurrence," the authors wrote. "Consideration of these factors could help guide surveillance for recurrences," they added.

SOURCE:

The study was led by Maya Mundada, University of California, San Francisco, and was published online on March 4 in JAMA Dermatology.

LIMITATIONS: 

Missing values of several pathologic variables was a limitation. Also, the study was conducted at a single institution with a relatively small number of recurrences.

DISCLOSURES:

The study received support from the Department of Defense; University of California, San Francisco; and the National Center for Advancing Translational Sciences, National Institutes of Health. One author disclosed receiving grants from the National Institutes of Health during the conduct of the study. No other disclosures were reported by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.