OUTCOMES OF PATIENTS WITH LOCAL RECURRENCE OF CUTANEOUS MALIGNANT-MELANOMA - A POPULATION-BASED STUDY

BACKGROUND, The definition of local recurrence of cutaneous malignant melanoma varies. The outcomes of patients with a local recurrence repo rted in the literature also vary, but the appearance of a local recurr ence has generally been considered a negative prognostic sign. Few stu dies have been population-based thus far. METHODS, During the period 1 976-1997, 3706 patients with cutaneous malignant melanoma (including 5 75 patients with melanoma in situ) were registered in a population-bas ed regional cancer registry. Local recurrence was defined as a recurre nce within the scar or transplant with no signs of regional or distant spread of the disease. Prognostic factors were investigated using uni variate and multivariate analytic techniques. The prognostic importanc e of a local recurrence in terms of survival was analyzed using the Co x proportional hazards regression model, with local recurrence as a ti me-dependent covariate. RESULTS, Local recurrence as a first event was rare (occurring in 48 of 3706 patients, or 1.3%). Twenty-eight percen t (11 of 39) of the patients with local recurrence of invasive primary melanoma developed distant metastases and subsequently died. Only ulc eration had prognostic significance in univariate analysis. A Cox anal ysis, with melanoma death as the endpoint and local recurrence as a ti me-dependent covariate, demonstrated a relative risk of 1.3 associated with local recurrence; however, this was not statistically significan t (confidence interval, 0.7-2.3). CONCLUSIONS, In this population-base d study, local recurrence was a rare event. The outcomes after diagnos is were relatively favorable. The results did not indicate a major det rimental effect on survival from the local recurrence per se. (C) 1997 American Cancer Society.