Hazard rates for recurrent and secondary cutaneous melanoma: An analysis of 33,384 patients in the German Central Malignant Melanoma Registry

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• 作者：Ulrike Leiter ; MD^a ; Petra G. Buettner ; PhD^b ; Thomas K. Eigentler ; MD^a ; Eva B. Brö ; cker ; MD^c ; Christiane Voit ; MD^d ; Harald Gollnick ; MD^e ; Wolfgang Marsch ; MD^f ; Uwe Wollina ; MD^g ; Friedegund Meier ; MD^a ; Claus Garbe ; MD^a ; ^b ; ^{claus.garbe@med.uni-tuebingen.de}
• 关键词：cutaneous melanoma ; hazard rates ; recurrences ; survival analysis
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2012
• 出版时间：January 2012
• 年：2012
• 卷：66
• 期：1
• 页码：37-45
• 全文大小：495 K

文摘

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Background

Knowledge about the risk for recurrence and secondary cutaneous melanoma (CM) is an important basis for patient counseling and planning of follow-up examinations.

Objectives

This study aimed to analyze stage- and time-dependent hazard rates (HR) and discusses current surveillance recommendations.

Methods

Follow-up data of 33,384 patients with incident CM in stages I to III (American Joint Committee on Cancer 2002) were recorded by the German Central Malignant Melanoma Registry in 1976 through 2007. Survival was based on Kaplan-Meier estimates and HRs were calculated.

Results

Recurrences were recorded in 4999 patients (stage I, 7.1 % ; stage II, 32.8 % ; and stage III, 51.0 % ). Ten-year recurrence-free survival was 78.9 % (95 % confidence interval 73.1-90.5); in stage I, 89.0 % ; stage II, 56.9 % ; and stage III, 36.0 % . Whereas HR for recurrent CM showed a constantly low level less than or equal to 1:125 per year for stage IA, clearly higher HRs of greater than or equal to 1:40 were recorded in stage IB for the first 3 years and generally in stages II to III. Of all patients 2.3 % developed secondary melanomas, with a consistently low HR of less than 1:220 per year.

Limitations

As German recommendations discontinued regular follow-up examinations after 10 years, no information can be given beyond this time point. Follow-up data of longer than 5 years were available in 41.4 % of patients.

Conclusion

For patients at stage IA with thin melanoma and low HR for recurrent CM the need for surveillance remains questionable. For patients with higher HR greater than 1:40 per year, intensified surveillance strategies should be taken into account.