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What are the key statistics for recurrence of melanoma?
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PeterBeitschMD (Physician - Surgery - Surgical Oncology (Verified) ) - 03 / 03 / 2012
Melanoma is the 5th most common cancer (other than sqaumous and basal skin cancer) but is only the 12th most common fatal cancer. This is probably due to the massive public education campaign that has been ongoing since the rapid rise in melanoma in the 90's (doubling in incidence since then). Almost all melanomas are caused by UV A/B radiation from the sun (there are rare melanomas such as ocular and mucosal [anal, oral] that account for <2% of all melanomas) and more recently from tanning beds.
Melanoma typically spreads in an orderly fashion from the skin to the regional lymph nodes that drain that skin and then elsewhere in the body. Fortunately, spread to the lymph nodes is unusual with < 20% of patients having lymph node metastasis. Spread elsewhere in the body is even rarer < 12-14% of patients developing systemic spread. Death from melanoma is rare (<10%) if no lymph nodes are involved but survival does decrease if if lymph nodes are involved to ~70% at 5 years and beyond. If the melanoma has spread beyond the skin/lymph nodes, survival decreases further and depends on where it has spread - subcutaneous fat (70%), lung/liver (40%) and brain (10%).
The chance of recurrence/spread is based on the microscopic characteristics of the melanoma. Factors that make it more likely to return are ulceration, increasing thickness, mitoses (number of cells seen dividing under the microscope) >1/millimeter, and vertical growth phase. There are 4 main types of melanoma - nodular, sperficial spreading, acral and lentigo, with nodular and acral (palms of hands/soles of feet) tend to be a little worse but prognosis is really more related to the thickness than the type.
Melanoma typically spreads in an orderly fashion from the skin to the regional lymph nodes that drain that skin and then elsewhere in the body. Fortunately, spread to the lymph nodes is unusual with < 20% of patients having lymph node metastasis. Spread elsewhere in the body is even rarer < 12-14% of patients developing systemic spread. Death from melanoma is rare (<10%) if no lymph nodes are involved but survival does decrease if if lymph nodes are involved to ~70% at 5 years and beyond. If the melanoma has spread beyond the skin/lymph nodes, survival decreases further and depends on where it has spread - subcutaneous fat (70%), lung/liver (40%) and brain (10%).
The chance of recurrence/spread is based on the microscopic characteristics of the melanoma. Factors that make it more likely to return are ulceration, increasing thickness, mitoses (number of cells seen dividing under the microscope) >1/millimeter, and vertical growth phase. There are 4 main types of melanoma - nodular, sperficial spreading, acral and lentigo, with nodular and acral (palms of hands/soles of feet) tend to be a little worse but prognosis is really more related to the thickness than the type.
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