Clinicopathological Factors Predicting Melanoma Recurrence: A Study From South East Ireland

Cutaneous malignant melanoma is a neoplastic transformation of melanocytes and a major cause of skin cancer-related mortality. Ireland, with its fair-skinned population, continues to see rising incidence rates, highlighting the importance of identifying clinicopathological predictors of recurrence.

To assess the relationship between excision margins and melanoma recurrence, with emphasis on anatomical distribution and clinicopathological features.

This retrospective observational study analyzed 565 patient records from University Hospital Waterford, Ireland, meeting predefined criteria. Data collected included age, sex, primary tumor site, disease stage, Breslow thickness, Clark level, mitotic figures, ulceration, lymphovascular invasion, sentinel lymph node involvement, and adequacy of excision margins. Statistical analysis was conducted using SPSS 26.0.

Significant predictors of recurrence included age ≥65 years, Breslow thickness >4.0 mm, Clark level IV-V, ulceration, lymphovascular invasion (P<0.001), and positive sentinel lymph node biopsy (P=0.004). Inadequate excision margins were also linked to increased recurrence. Conversely, early-stage disease, thin Breslow lesions (≤1.0 mm), and Clark level II were associated with lower recurrence risk.

This study demonstrates a significant association between narrow excision margins and melanoma recurrence, particularly in anatomically complex areas like the head and neck. The findings underscore the importance of individualized surgical planning to ensure oncological safety while preserving function and appearance. Adherence to excision margin guidelines and long-term follow-up are essential, especially in patients with high-risk histological features.