Melanoma: risk factors differ for lymphatic and hematogenous metastasis

  • Calomarde-Rees L & al.
  • JAMA Dermatol
  • 1 may. 2019

  • de Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • In patients with stage I/II cutaneous melanoma, age, primary site, and thickness are associated with lymphatic metastasis, while thickness, TERT promoter status, and BRAF mutation status are associated with hematogenous metastasis.

Why this matters

  • Risk factor identification will aid follow-up and adjuvant treatment strategies.

Key results

  • 9.2% of patients developed lymphatic metastasis and 9.2% developed hematogenous metastasis.
  • Age >55 years (HR, 1.9; P=.01), head/neck primary (HR, 1.7; P=.04), acral primary (HR, 2.4; P=.005), Breslow thickness (HR, 5.1, P<.001 for mm hr>4.00 mm) were associated with lymphatic metastasis in multivariate analysis.
  • Breslow thickness (HR, 4.2; P=.007 for 1.01-2.00 mm; HR, 13.5; P<.001 for mm>4.00 mm), TERT promoter mutation (HR, 2.9; P=.001), and BRAF mutation (HR, 1.9; P=.03) were associated with hematogenous metastasis in multivariate analysis.

Study design

  • 1177 patients with stage I/II cutaneous melanoma were analyzed for metastases and associated factors.
  • Funding: None disclosed.

Limitations

  • Retrospective study.