Identifying factors that predict melanoma recurrence

Dr Julia Matheson, Dr David Gyorki – October 2013 (data)

Most melanomas are identified early and have an excellent prognosis. However a small percentage of patients with early melanomas develop recurrent disease. In this study we assessed if factors previously shown to be significant in predicting early melanoma (Stage I and II) recurrence were consistent in the Melbourne Melanoma Project (MMP) patient cohort. We then sought to identify new prognostic factors associated with recurrence.

1029 patients were included in the analysis. 123 of these patients developed a recurrence during follow up (median follow up 2.13 years). Ulceration, presence of mitoses, Clark level (melanoma thickness), presence of lymphovascular invasion and a history of autoimmune disease were identified as factors independently associated with recurrence. We identified a group of patients with very low risk of recurrence: those with no ulceration, no mitoses, thin melanomas and no lymphovascular invasion. This is a cost effective way of identifying low risk patients who do not require intensive follow up. For such patients annual reviews and skin checks may be appropriate. This study has helped to inform follow up protocols for melanoma patients at the Peter MacCallum Cancer Centre.

Associated publication:

Matheson JA, te Marvelde L, Mailer S, Speakman D, Spillane J, Henderson MA, Gyorki DE. Prospective evaluation of prognostic indicators for early recurrence in cutaneous melanoma. Melanoma Research. In Press 2016