Metastatic patterns, clinical outcome, and malignant phenotype in malignant cutaneous melanoma

The objective of this population-based study was to assess metastatic pathw ays and outcomes vs, selected clinical and histopathologic features of the primary tumor in patients with recurrent cutaneous malignant melanoma. At a median follow-up time of 11 years, 569/2493 patients with recurrence were identified. We demonstrated a 5-year survival rate of 82% and 30% among tho se with a primary local or regional recurrence, respectively. Patients with primary distant skin, distant lymph node, or pulmonary metastases had a si gnificantly better survival compared with those with CNS, bone, visceral, l iver, or multiple sites of first distant metastases. The metastatic pathway s were similar with regard to histogenetic type, primary tumor thickness, C lark's level of invasion, and primary tumor ulceration. Different histogene tic types, as assessed by light microscopy, imply different risks of recurr ence. However, once the recurrence is manifest, the metastatic pathways are uniform, as well as prognosis, and survival.