Detection of disease recurrence in real-world patients with completely resected stage III cutaneous melanoma
DOI:
https://doi.org/10.2340/1651-226X.2026.45609Keywords:
Melanoma Cutaneous Malignant, Tomography, X-Ray Computed, Whole body imaging, Neoplasm Metastasis, Neoplasm Recurrence, Follow-up studiesAbstract
Background and purpose: Optimal postoperative follow-up for high-risk cutaneous melanomas (CM) is unclear. We aimed to evaluate disease recurrences in patients with stage III CM before modern adjuvant therapies.
Patient/material and methods: Three hundred and fifty patients with a median follow-up of 8.9 years at Helsinki University Hospital Comprehensive Cancer Center after complete resection of stage IIIA–D CM between 2008 and 2017 were identified. Information on baseline characteristics, recurrence patterns and survival were collected from electronic medical records.
Results: One hundred and ninety patients (54.3%) developed disease recurrence with 258 recurrence events documented. Local recurrence occurred in 14.5, 27.0, 32.3 and 44.4% and distant metastases in 21.7, 40.5, 52.4 and 83.3% of patients with stage IIIA, IIIB, IIID and IIID, respectively. Median recurrence-free survival was not reached and 7.4 years in stage IIIA and IIIB compared to 2.9 and 0.9 years in IIIC and IIID. Routine computed tomography (CT) imaging revealed 51% of all recurrences and 64% of distant metastases. 13.2% of distant recurrences involved skin and soft tissues, 31.4 lungs, 34.0 other visceral organs and 21.5% brain. First recurrences occurred mostly during the first 2 years of follow-up (59.5–100% in stage IIIB–D) except for stage IIIA (45.0%). Most of recurrences detected by patients (58.0%), physical exams or ultrasound (76.1%) and routine CT (61.2%) occurred during the first 2 years.
Interpretation: High rate of recurrences and distant metastases supports routine physical exams and CT particularly during the first years of postoperative follow-up, especially in stage IIIB–D CM.
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Copyright (c) 2026 Tiina Peuranheimo, Anni Hellman, Siru Mäkelä, Kalle E Mattila, Micaela Hernberg
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