Predictive factors for distant metastasis in early cutaneous melanoma: a 20-year experience of a Turkish tertiary referral hospital
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Melanoma is an aggressive skin cancer with a high metastatic potential and mortality risk. Identifying risk factors for distant metastasis is crucial for optimizing surveillance strategies. The authors aimed to evaluate the predictors of distant metastasis in early-stage cutaneous melanoma within a Turkish patient cohort. METHODS: A retrospective cohort study was conducted on patients with stage I-II melanoma, diagnosed between 2004 and 2024 at the Department of Dermatology, Dokuz Eylul University. A minimum follow-up period of five years was ensured. Demographic, clinical, and histopathological variables were analyzed for their association with distant metastasis using univariate and multivariate statistical models. RESULTS: Among 148 patients, distant metastasis occurred in 36 (24.3%) during follow-up. Multivariate analysis identified age (HR = 1.03 per year, p = 0.050), Breslow thickness (HR = 1.19 per mm, p = 0.008), ulceration (HR = 3.05, p = 0.028), and Lymphovascular Invasion (LVI) (HR = 4.20, p = 0.002) as significant independent predictors of distant metastasis. The risk was found to increase markedly, particularly after the age of 40. Additionally, the optimal cut-off value for Breslow thickness was determined to be 2.73 mm, with a sensitivity of 69% and a specificity of 71% based on ROC curve analysis. CONCLUSION: Increasing age, Breslow thickness, ulceration, and LVI were identified as independent risk factors for distant metastasis in early-stage cutaneous melanoma. Notably, patients over 40-years and those with Breslow thickness >2.73 mm were at significantly higher risk. Further studies are warranted to validate these results and facilitate their integration into clinical practice.
Authors: Ozlem Ozbagcivan, Elif Kazaz
Institution: Dokuz Eylül University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,700
OpenAlex ID: W4415569291