title: Risk factors associated with local and in-transit recurrence of cutaneous melanoma.
abstract: BACKGROUND
  Understanding the risk factors for local and in-transit recurrences (LR/ITR) may help facilitate methods of prevention, early detection, and treatment.
  
  
  METHODS
  A retrospective review of a prospectively collected database was performed on patients diagnosed with single-lesion cutaneous melanoma. Clinical and pathologic characteristics of the tumors were evaluated.
  
  
  RESULTS
  Of 225 patients, 10% had LR/ITR. Patients with LR/ITR were older (P = .0002), had thicker tumors (P = .018), and positive angiolymphatic invasion more frequently (P < .0001). An increased tumor mitotic rate (TMR) was more common in LR/ITRs (P = .051). On univariate logistic regression, age, thickness, TMR of 11/mm(2) or greater, and angiolymphatic invasion were all significant risk factors for LR/ITR. Multivariate logistic regression showed age, thickness, and angiolymphatic invasion were the only significant risk factors.
  
  
  CONCLUSIONS
  Older patients with thicker tumors and angiolymphatic invasion appear to be at higher risk for LR/ITR. Such patients warrant consideration of preventative strategies and should receive close clinical follow-up evaluation for early recurrence.
authors.affiliation: Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ 85054, USA.
authors.forename: Chee-Chee H
authors.initials: CC
authors.lastname: Stucky
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gray
authors.forename: Amylou C
authors.initials: AC
authors.lastname: Dueck
authors.forename: Nabil
authors.initials: N
authors.lastname: Wasif
authors.forename: Susan D
authors.initials: SD
authors.lastname: Laman
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Sekulic
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pockaj
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery