Main risk factors for local recurrence in patients with cutaneous melanoma - single center study

Introduction. True scar recurrence (persistent disease) that develops at the site of wide excision of primary cutaneous melanoma is defined as the presence of in situ and/or radial phase of growth of a melanoma that is within or near the surgical scar This study aims to present the main risk factors associated with the appearance of local recurrence in patients with melanoma of the skin, as well as the negative impact of local recurrence on overall survival. Material and methods. We included 144 patients with skin melanoma in the study who were operated on at UMHAT "Dr. Georgi Stranski" Pleven, Bulgaria, during the period 2012-2017. Results. Achromic skin melanoma was significantly (chi 2 = 15.668; df = 1; p = 0.001) more frequent in patients with locally recurrent melanoma. Metastatic melanoma was more common in patients with local recurrence (73% vs. 16.3%; chi 2 = 25.308; df = 1; p = 0.001). The overall median survival of all patients was 75.9 [95% confidence interval (CI) 69.7-82.0] months and it was lower [95% CI 52.8 (39.8-65.8) vs. 95% CI 77.7 (71.1-84.2)] in patients with local melanoma recurrence, although the differences were not significant (p = 0.076). Conclusions. The achromic type and the greater thickness and depth of invasion of the primary skin melanoma are major risk factors for the development of local recurrence. The presence of local recurrence of the disease is associated with a high rate of distant metastases. The development of local recurrence in patients with cutaneous melanoma significantly worsens the overall survival of the disease.