title: Prognosis associated with cutaneous melanoma metastases.
abstract: OBJECTIVE
  Information on the prognosis for patients with regional cutaneous melanoma metastases has been sparse and difficult to establish. In 2009 the American Joint Committee on Cancer (AJCC) melanoma staging has for the first time provided survival rates for patients who manifest intralymphatic metastases. We sought to validate the new staging system in this contemporary, prospectively collected cohort of patients following the development of cutaneous metastases as the first evidence of metastatic disease and explored the factors that influenced their prognosis.
  
  
  METHODS
  The Victorian Melanoma Service database was searched to identify all patients with cutaneous melanoma metastases. Patients who were found to have lymph node or visceral metastases at the time they were diagnosed with cutaneous metastatic disease were excluded. Survival curves were generated and univariate and multivariate assessments of prognostic factors associated with survival were performed.
  
  
  RESULTS
  In total, 72 patients presented with cutaneous metastases as the first evidence of metastatic disease. The median melanoma-specific survival of patients with only regional cutaneous metastases (n = 56) was 5.07 years and their 5-year survival rate was 52%. Distant cutaneous metastases and thickness of the primary melanoma were found to be significant negative predictors of survival.
  
  
  CONCLUSIONS
  We were able to validate the new AJCC melanoma staging system survival for patients with cutaneous metastatic disease. Patients presenting with regional cutaneous metastases have a much better prognosis than those with distant cutaneous metastases.
authors: Victorian Melanoma Service, The Alfred, Melbourne, Victoria, Australia.
authors: Yan
authors: Y
authors: Pan
authors: Andrew M
authors: AM
authors: Haydon
authors: Catriona A
authors: CA
authors: McLean
authors: Priska B B
authors: PB
authors: McDonald
authors: John W
authors: JW
authors: Kelly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000556:secondary; D015996:Survival Rate; D055815:Young Adult
keywords: cutaneous melanoma metastasis; prognosis