Recurrence in Patients with Thin Melanomas Linked with Poor Prognosis, Despite Rarity

While rare, the recurrence of melanomas in patients with thin melanomas was linked with poorer prognosis and lower survival rates, a single-center analysis reported.

"The majority of patients diagnosed with melanoma have thin melanomas (≤1 mm)," the researchers wrote in their study, published in Melanoma Research. "Data on the rate and pattern of recurrence after a negative sentinel lymph node biopsy (SLNB) are sparse."

The authors retrospectively searched a single-center institutional database for records of patients with thin melanomas who underwent SNLB with negative results. Of the 198 study patients with thin melanomas, 13 (6.5%) had tumor recurrence [two local in transit (15.4%), three regional (21.3%), and eight distant (61.5%)], with distant recurrences tending to occur later than local occurences. A higher percentage of patients with tumor thickness ≥0.8 mm was reported among those with sustained recurrence. Almost 70% of the patients were not actively being followed up when diagnosed, presenting instead with clinical symptoms. 

The authors reported that patients with recurrence had significantly lower survival compared with those without recurrence (181 months vs. ongoing survival, P<0.001, respectively).

"Melanoma recurrence in patients with thin melanomas and negative SLNBs is rare, tends to be distant, and negatively affects prognosis," the authors concluded. "Recurrence tends to occur in patients with melanoma thickness ≥0.8 mm. Further studies are needed to identify patients with high recurrence risk and determine optimal follow-up protocols."

Source: Maayan S, et al. Melanoma Research. 2024. Doi:10.1097/CMR.0000000000000986