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Douglas S. Reintgen, MD; Robin Vollmer, MD; C. Y. Tso, PhD; Hilliard F. Seigler, MD

Arch Surg. 1987;122(11):1338-1342.

Abstract
• The outcome of patients with stage I malignant melanoma has been well assessed in terms of prognostic factors and their effect on survival; however, little is known of the recurrence patterns of cutaneous melanoma or the survival of these patients subsequent to recurrence. A retrospective, computer-aided chart review identified 4185 patients with melanoma who had stage I disease clinically. During a follow-up period of one to 14 years, 35.9% suffered a recurrence. Melanoma of the trunk (37.8%) and head and neck area (46.1%) had an increased incidence of recurrent metastases compared with melanoma of the extremities (29.8%). Local regional metastases accounted for 62.5%, 77.3%, and 85.6% of the recurrences in the head and neck, trunk, and extremity primary sites, respectively, with 65% of the relapses occurring within the first three years. Actuarial five-year survival rates of patients who had recurrent disease were significantly decreased compared with those of patients who had no evidence of metastases during their clinical course. A multivariate analysis was performed to estimate the survival of patients after recurrence. One may use this mathematical model to predict the outcome of individual patients after recurrence and provide a more rationally based prognosis for them and their families.

(Arch Surg 1987;122:1338-1342)

Author Affiliations
From the Departments of Surgery (Drs Reintgen and Seigler) Bio-statistics (Dr Tso), and Pathology (Dr Vollmer), Duke University Medical Center, Durham, NC. Dr Reintgen is a recipient of the Armand Hammer Travel Award for the 1987 meeting.

Footnotes
Accepted for publication July 29, 1987.

Read before the Annual Meeting of the Society of Surgical Oncology, London, April 27, 1987.

Reprint requests to PO Box 3966, Duke University Medical Center, Durham, NC 27710 (Dr Seigler).

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