What are the risk factors for melanoma relapse after 10 years?

The authors evaluated the risk factors for late spread of melanoma in patients disease-free for 10 to 15 years.

Researchers concluded that age at time of diagnosis and tumor thickness are predictors of late melanoma relapse. 

Early stage melanoma patients are often considered ‘cured’ after 10 or more disease-free years. However, in 0.4 to 6% of patients, melanoma may return even 10 years or more after first diagnosis. There are currently no clear guidelines on how to monitor melanoma patients 10 to 15 years following initial treatment. To understand the risk factors of late relapse, a large patient population and a long follow-up are required. In this study, the authors investigated factors that could help predict late stage spread of melanoma in patients disease-free for more than 10 years.  

1372 patients with a history of early stage (I or II) melanoma, disease-free for 10 years, were included in this study. Participants were followed for an average of 5.4 years. Overall, 77 patients (5.6%) experienced late melanoma relapse. 52 patients had relapse at the original site of cancer. 31 out of these 52 patients had melanoma in regional lymph nodes. Overall, 25 patients had cancer spread to other parts of the body. Out of these, in 40% the melanoma had spread to the brain, and in 48% had spread to lungs.

Patients below 40 years of age and with a tumor thickness of greater than 2 mm during original melanoma diagnosis had a higher chance of cancer return. 

The authors concluded that patients with high risk melanoma characteristics may benefit from regular recurrence screening beyond 10 years.