Retrospective study of factors affecting recurrence and survival among patients with high-risk stage II melanoma

In the current era of effective adjuvant therapies and de-escalation or surgery, distinguishing which patients with high-risk stage II melanoma are at increased risk of recurrence after excision of the primary lesion is important. Retrospective analysis of patients with stage IIB or IIC melanoma at Massachusetts General Hospital (2009-2022) investigated factors affecting recurrence and survival. Breslow depth greater than 4 mm, higher mitotic rate, advanced T stage, and KIT mutation had negative impact on relapse-free survival. Primary lesion in head and neck, mitotic rate exceeding 10 mitoses per mm2, CDH1 mutation, and KIT mutation were associated with shorter distant metastasis-free survival. Overall survival and melanoma-specific survival were lower with older age at diagnosis. The authors conclude that traditional histopathologic factors and specific tumor mutations were associated with disease recurrence and survival among patients with high-risk stage II melanoma.