FIRST METASTASIS OF MALIGNANT-MELANOMA 10 OR MORE YEARS AFTER TREATMENT

36 (3,5%) of 1015 patients who had ten or more years of follow up afte r treatment of invasive malignant melanomas (stage I and II, UICC 1978 ) in Hornheide 1967-1984 developed late metastases. The mean disease-f ree interval was 12.5 years. These patients were younger (mean age of 45.8 years) compared to the age of all melanoma patients at the time o f primary therapy. The rate of late relapses was 2,8% in women (20/705 ) and 5% in men (16/310). ln melanomas located on the trunk or on the legs in male individuals,the relapse was twice as high as in females,T he median tumor thickness in patients with late progression was 1,5 mm ;in patients without relapse, 1.2 mm. The well known association of tu mor thickness with the risk of metastases disappeared after a 10 years disease-free interval. The frequency of metastases (3.5%) did not var y in different thickness classes from 0.76 mm to 3 mm or more. Melanom as with a Breslow thickness < 0,75 mm had a risk of only 1.4%. 23 pati ents (64%) developed distant,only 13 (36%) regional late metastases as first evidence of recurrent disease. The survival of these patients c orrelated neither to the duration of previous relapse-free follow up, nor to site of the primary lesion nor to sex. lt correlated only to th e site of metastases: 83% of all patients with distant late metastases had a remaining life time of 14 months or less, but patients with reg ional metastases survived more than 7 years in 69% of the cases. We ha ve been unable to define risk factors for late metastases.