title: Predictive factors for loco regional recurrence and distant metastasis following primary surgical treatment of cutaneous melanoma.
abstract: BACKGROUND
  Cutaneous melanoma (CM) has a high propensity for regional and systemic spread. This is one of the largest series of CM reported from India.
  
  
  OBJECTIVE
  To predict factors for loco regional recurrence (LRR) and distant metastasis in patients with CM primarily treated with surgery.
  
  
  METHODS
  Retrospective analysis of patient database at a tertiary care cancer center with evaluation of factors for LRR and distant metastasis for CM.
  
  
  METHODS
  Data from 68 patients treated for CM between January 2006 and December 2010 were reviewed. Data recorded included age, sex, symptoms, investigations, treatment given, histopathology, recurrence and follow-up. Patient factors, tumor factors, pathologic variables, and adjuvant treatment were investigated as predictors' of LRR and distant metastasis.
  
  
  RESULTS
  Mean age of patients was 54 years. Melanoma was more common in males (44). Tumor thickness > 4 mm was found in 43 patients. Lymph node involvement was found in 43 patients. Adjuvant radiotherapy was given in seven patients. At mean follow-up of 16.5 months, LRR was seen in 34 patients and distant metastasis in 28 patients. LRR and distant metastasis were more commonly found in females, age > 40 years, Clark's level IV and V, Breslow's depth > 4 mm, patients with lymph node involvement and extra-capsular spread.
  
  
  CONCLUSIONS
  The age, sex, site, thickness of lesion, involvement of lymph node, and extra-capsular spread were important factors in predicting LRR and distant metastasis. Distant metastasis was also more commonly found in patients with LRR.
authors.affiliation: Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Vijayalakshmi
authors.initials: V
authors.lastname: Deshmane
authors.affiliation: Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Kalloli
authors.affiliation: Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Santosh
authors.initials: S
authors.lastname: Chikaraddi
authors.affiliation: Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: Br
authors.initials: B
authors.lastname: Keerthi
authors.affiliation: Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India.
authors.forename: R
authors.initials: R
authors.lastname: Krishnappa
keywords: Cutaneous melanoma; distant metastasis; locoregional recurrence; predictive factors for recurrence; prognostic factors