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Prognosis after initial recurrence of cutaneous melanoma
J S Markowitz1, L A Cosimi, R W Carey
1General Surgical, Massachusetts General Hospital, Boston 02114.
Archives of Surgery (Chicago, Ill. : 1960)
|June 1, 1991
Summary
For cutaneous melanoma patients with recurrent disease, surgical removal of metastases offers the best chance of long-term survival. Complete eradication of disease, regardless of recurrence site, is crucial for improved outcomes.
Area of Science:
- Oncology
- Dermatology
- Surgical Oncology
Background:
- Cutaneous melanoma is a significant public health concern.
- Recurrence after initial treatment impacts patient prognosis.
- Understanding prognostic factors for recurrent melanoma is vital.
Observation:
- A review of 231 patients with recurrent clinical stage I cutaneous melanoma was conducted.
- Treatment strategies included surgical resection, adjuvant therapies, and local irradiation.
- Recurrence occurred 1 to 218 months post-initial surgical therapy.
Findings:
- The overall 5-year survival rate after initial recurrence was 36%.
- Survival rates varied by recurrence site: 49% for soft tissue, 38% for nodal, and 11% for visceral.
- Complete eradication of gross disease through surgery or chemotherapy significantly improved survival.
Implications:
- Aggressive surgical management of metastatic lesions is recommended.
- Adjuvant therapies and local irradiation play roles in managing unresectable disease.
- Prognosis is influenced by metastasis site and successful disease eradication, not primary tumor characteristics.