[Cutaneous melanoma: long-term outcomes in a healthcare area with structured follow-up. Implications for primary care]

Cutaneous melanoma is responsible for the highest mortality among skin cancers, and its prognosis depends on the stage at diagnosis. The aim of this study was to describe the clinical characteristics and long-term outcomes of cutaneous melanoma in a healthcare area with structured follow-up coordinated with Primary Care, and to analyse its implications for real-world clinical practice.

A cohort study including all cutaneous melanomas managed between 2008 and 2018 in a reference healthcare area was conducted, with protocolised follow-up. Clinical and histopathological variables were collected, and incidence, melanoma-specific mortality and survival were estimated.

A total of 176 melanomas were included. Incidence was 9.07 cases per 100,000 person-years, and melanoma-specific mortality was 0.62 per 100,000 person-years, lower than that reported in contemporary national series. Most melanomas (75.0%) were diagnosed at stages 0-I, with 24.4% being melanoma in situ; 57.5% of invasive melanomas had a Breslow thickness ≤1mm. Five-year melanoma-specific survival was 91.8%. In multivariate analysis, both age and Breslow thickness were independently associated with melanoma-specific mortality (HR: 1.04 [95%CI: 1.01-1.08] and HR: 1.48 [95%CI: 1.26-1.74], respectively).

A predominance of early-stage diagnoses and high long-term survival was observed, with melanoma-specific mortality lower than that reported in national series. These findings reinforce the importance of early diagnosis and the relevance of coordinated care in the management of cutaneous melanoma.