Study: Tumor Location and Histologic Features Linked to Melanoma Recurrence
Key Takeaways
Several clinicopathologic factors beyond Breslow thickness and ulceration were associated with melanoma recurrence in stage I–II disease, according to a new analysis.
Tumor location on the scalp, neck, or face and histopathologic features such as neurotropism, lymphovascular invasion, and mitotic activity were linked to shorter time to recurrence.
Findings suggest additional variables may help refine surveillance strategies for patients with localized melanoma.
In patients with stage I–II melanoma, tumor location and histopathologic features were linked with recurrence risk beyond traditional factors such as ulceration and tumor thickness, according to a new study.
Investigators examined patients diagnosed with localized cutaneous melanoma between 2010 and 2017. Individuals with multiple melanomas during the study period, recurrent index tumors, or noncutaneous melanomas were excluded. The final cohort included 1,092 patients. Median age at diagnosis was 60 years (57.0% were male). Most patients were White (96.7%). The primary study outcomes were melanoma recurrence and time to recurrence.
According to multivariable analysis, there were six factors significantly associated with recurrence risk. Ulceration showed a strong association with shorter time to recurrence (HR = 3.48; 95% CI, 2.51 to 4.82; P < 0.001). Increasing tumor thickness was also associated with recurrence (HR = 1.09; 95% CI, 1.05 to 1.13; P < 0.001). Tumor location was relevant, with scalp or neck lesions (HR = 3.22; 95% CI, 1.94 to 5.37; P < 0.001) and facial lesions (HR, 2.14; 95% CI, 1.29 to 3.53; P = 0.003) showing higher recurrence risk compared with tumors on the arms. Additional histopathologic features associated with recurrence included neurotropism (HR = 0.96; 95% CI, 1.03 to 3.72; P = 0.04), lymphovascular invasion (HR = 2.52; 95% CI, 1.00 to 6.34; P = 0.049), and mitotic activity (HR = 3.93; 95% CI, 2.47 to 6.26; P < 0.001).
“In this study, for localized melanomas, variables beyond those currently considered standard for staging for survival prognosis were associated with time to melanoma recurrence; consideration of factors beyond thickness and ulceration could be valuable in helping to guide surveillance for recurrences,” the authors wrote in the study.
Source: JAMA Dermatology. 2026. Doi: