Analysis of prognosis and disease progression after local recurrence of melanoma

Xiang O. Dong, Douglas Tyler, Jeffrey L. Johnson, Pierre DeMatos, Hilliard F. Seigler

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

BACKGROUND. Local recurrence of melanoma is associated with a grave prognosis. However, the characteristics and the mode of disease progression for patients with local recurrence have not been adequately addressed in the literature. METHODS. A retrospective analysis of patients treated at a single institution revealed a subset of patients (n = 648) with local recurrence of melanoma as a first event. Patient characteristics, histologic determinants, and disease free interval were variables used to identify prognostic factors. RESULTS. In this group of patients, male gender (P = 0.0163), increasing age (P = 0.0001), head and neck primaries (P = 0.0001), thicker Breslow depths (P = 0.0022), deeper Clark levels (P = 0.0010), and ulceration of the primary tumor (P = 0.0348) suggested a shorter time until local recurrence. Breslow depth (P = 0.0004), Clark level (P = 0.0043), and ulceration (P = 0.0001) still factored into the survival prognosis after recurrence. Truncal primaries (P = 0.0005) and shorter disease free intervals (P = 0.0098) were also associated with poorer outcomes after recurrence. Of the 648 patients, 124 showed no progression, 196 developed another local recurrence, 178 developed in-transit/lymph node metastases, and 150 had systemic recurrences. Survival was only 33.6% for patients with further metastases, compared with 77.4% for patients with no progression of disease after a median follow-up of 38.9 months. CONCLUSIONS. There was a 48.5% mortality rate at 5 years of follow-up after local recurrence. Long term survival (> 10 years) was estimated to be 34.9%. The patterns of failure after local recurrence suggest that patients may benefit from aggressive locoregional therapy. (C) 2000 American Cancer Society.

Original languageEnglish (US)
Pages (from-to)1063-1071
Number of pages9
JournalCancer
Volume88
Issue number5
DOIs
StatePublished - Mar 1 2000
Externally publishedYes

Fingerprint

Disease Progression
Melanoma
Recurrence
Survival
Neoplasm Metastasis
Neck
Lymph Nodes
Head
Mortality

Keywords

  • Disease free interval
  • Local recurrence
  • Melanoma
  • Melanoma metastasis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Analysis of prognosis and disease progression after local recurrence of melanoma. / Dong, Xiang O.; Tyler, Douglas; Johnson, Jeffrey L.; DeMatos, Pierre; Seigler, Hilliard F.

In: Cancer, Vol. 88, No. 5, 01.03.2000, p. 1063-1071.

Research output: Contribution to journalArticle

Dong, Xiang O. ; Tyler, Douglas ; Johnson, Jeffrey L. ; DeMatos, Pierre ; Seigler, Hilliard F. / Analysis of prognosis and disease progression after local recurrence of melanoma. In: Cancer. 2000 ; Vol. 88, No. 5. pp. 1063-1071.
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abstract = "BACKGROUND. Local recurrence of melanoma is associated with a grave prognosis. However, the characteristics and the mode of disease progression for patients with local recurrence have not been adequately addressed in the literature. METHODS. A retrospective analysis of patients treated at a single institution revealed a subset of patients (n = 648) with local recurrence of melanoma as a first event. Patient characteristics, histologic determinants, and disease free interval were variables used to identify prognostic factors. RESULTS. In this group of patients, male gender (P = 0.0163), increasing age (P = 0.0001), head and neck primaries (P = 0.0001), thicker Breslow depths (P = 0.0022), deeper Clark levels (P = 0.0010), and ulceration of the primary tumor (P = 0.0348) suggested a shorter time until local recurrence. Breslow depth (P = 0.0004), Clark level (P = 0.0043), and ulceration (P = 0.0001) still factored into the survival prognosis after recurrence. Truncal primaries (P = 0.0005) and shorter disease free intervals (P = 0.0098) were also associated with poorer outcomes after recurrence. Of the 648 patients, 124 showed no progression, 196 developed another local recurrence, 178 developed in-transit/lymph node metastases, and 150 had systemic recurrences. Survival was only 33.6{\%} for patients with further metastases, compared with 77.4{\%} for patients with no progression of disease after a median follow-up of 38.9 months. CONCLUSIONS. There was a 48.5{\%} mortality rate at 5 years of follow-up after local recurrence. Long term survival (> 10 years) was estimated to be 34.9{\%}. The patterns of failure after local recurrence suggest that patients may benefit from aggressive locoregional therapy. (C) 2000 American Cancer Society.",
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T1 - Analysis of prognosis and disease progression after local recurrence of melanoma

AU - Dong, Xiang O.

AU - Tyler, Douglas

AU - Johnson, Jeffrey L.

AU - DeMatos, Pierre

AU - Seigler, Hilliard F.

PY - 2000/3/1

Y1 - 2000/3/1

N2 - BACKGROUND. Local recurrence of melanoma is associated with a grave prognosis. However, the characteristics and the mode of disease progression for patients with local recurrence have not been adequately addressed in the literature. METHODS. A retrospective analysis of patients treated at a single institution revealed a subset of patients (n = 648) with local recurrence of melanoma as a first event. Patient characteristics, histologic determinants, and disease free interval were variables used to identify prognostic factors. RESULTS. In this group of patients, male gender (P = 0.0163), increasing age (P = 0.0001), head and neck primaries (P = 0.0001), thicker Breslow depths (P = 0.0022), deeper Clark levels (P = 0.0010), and ulceration of the primary tumor (P = 0.0348) suggested a shorter time until local recurrence. Breslow depth (P = 0.0004), Clark level (P = 0.0043), and ulceration (P = 0.0001) still factored into the survival prognosis after recurrence. Truncal primaries (P = 0.0005) and shorter disease free intervals (P = 0.0098) were also associated with poorer outcomes after recurrence. Of the 648 patients, 124 showed no progression, 196 developed another local recurrence, 178 developed in-transit/lymph node metastases, and 150 had systemic recurrences. Survival was only 33.6% for patients with further metastases, compared with 77.4% for patients with no progression of disease after a median follow-up of 38.9 months. CONCLUSIONS. There was a 48.5% mortality rate at 5 years of follow-up after local recurrence. Long term survival (> 10 years) was estimated to be 34.9%. The patterns of failure after local recurrence suggest that patients may benefit from aggressive locoregional therapy. (C) 2000 American Cancer Society.

AB - BACKGROUND. Local recurrence of melanoma is associated with a grave prognosis. However, the characteristics and the mode of disease progression for patients with local recurrence have not been adequately addressed in the literature. METHODS. A retrospective analysis of patients treated at a single institution revealed a subset of patients (n = 648) with local recurrence of melanoma as a first event. Patient characteristics, histologic determinants, and disease free interval were variables used to identify prognostic factors. RESULTS. In this group of patients, male gender (P = 0.0163), increasing age (P = 0.0001), head and neck primaries (P = 0.0001), thicker Breslow depths (P = 0.0022), deeper Clark levels (P = 0.0010), and ulceration of the primary tumor (P = 0.0348) suggested a shorter time until local recurrence. Breslow depth (P = 0.0004), Clark level (P = 0.0043), and ulceration (P = 0.0001) still factored into the survival prognosis after recurrence. Truncal primaries (P = 0.0005) and shorter disease free intervals (P = 0.0098) were also associated with poorer outcomes after recurrence. Of the 648 patients, 124 showed no progression, 196 developed another local recurrence, 178 developed in-transit/lymph node metastases, and 150 had systemic recurrences. Survival was only 33.6% for patients with further metastases, compared with 77.4% for patients with no progression of disease after a median follow-up of 38.9 months. CONCLUSIONS. There was a 48.5% mortality rate at 5 years of follow-up after local recurrence. Long term survival (> 10 years) was estimated to be 34.9%. The patterns of failure after local recurrence suggest that patients may benefit from aggressive locoregional therapy. (C) 2000 American Cancer Society.

KW - Disease free interval

KW - Local recurrence

KW - Melanoma

KW - Melanoma metastasis

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