Outcome following local recurrence or in-transit metastases in cutaneous melanoma.

Defining clinical factors influencing outcome after local recurrence or in-transit metastasis may help us to improve treatment and develop follow-up guidelines. A retrospective review of melanoma patients with local recurrence in the primary tumor scar or with in-transit metastasis was carried out. Outcome and survival were analyzed for 99 patients. In univariate analysis, factors related to overall survival following local recurrence at the time of the first relapse were initial stage [P=0.002, hazard ratio (HR) 1.9], site of primary tumor (P=0.02, HR 1.1), Breslow thickness (P=0.002, HR 1.2), Clark classification (P=0.01, HR 1.7), ulceration (P=0.01, HR 2.1), presence of satellite tumor (P=0.03, HR 2.7), and development of lymph node or distant metastases during follow-up (P<0.001, HR 7.0). Local recurrence within 2 years after surgery of primary melanoma correlated with worse survival (P=0.02, HR 2.1). Patients with local recurrence as first relapse often have a poor prognosis if the disease recurs within 2 years after primary surgery.