423P - Positive lymph node and thicker Breslow are associated with poor prognosis of high-risk resected melanomas

Background

Nodular, acral, and mucosal melanomas that represent non-cumulative sun damage lesions account for more than 60% of melanomas in Asia but comprise only 4% in Caucasians. The distinct spectrum of manifestations might influence the clinical course and outcomes. Factors associated with the prognosis of high-risk resected melanomas from Indonesia have not yet been previously reported.

Methods

Demographic, clinical, pathological characteristics of 82 melanoma patients who underwent complete resection in 2014-2019 were analyzed.

Results

Nodular melanoma (NM), mucosal melanoma (MM), and acral lentiginous melanoma (ALM) made up of 42.7% (n=35), 42.7% (n=35), and 14.2% (n=12) of cases, respectively. Most patients were diagnosed at advanced stages (76.8%, n=63 at Stage III-IV). For cutaneous melanomas, 89% (N=42) patients were found with Breslow’s tumor thickness more than 4 mm, 51% (N=24) with ulceration, 93% (N=43) with diameter more than 6 mm, 59% (N=28) with lymphovascular invasion, and 74% (N=35) with regional lymph node infiltration. In mucosal melanomas, 14.5% (N=5) were diagnosed with regional spread to lymph nodes and 77% cases (N=27) were found with regional infiltration beyond mucosa. Regional lymph node spread was associated with shorter overall survival (median survivals were 17 vs 23.4 months, Mantel-Cox test p=0.049). Patients diagnosed at T4 were also associated with poor overall survival (median survivals were 23 vs 32 months, Mantel-Cox test p=0.047).

Conclusions

Most melanoma patients in Indonesia were found as a higher risk for recurrence after the initial complete resection. Regional lymph node infiltration and thicker tumor (T4) were associated with poor prognosis. Early detection and advancement of treatment strategy are required to improve the survivals of melanoma patients in Indonesia.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Sumadi Lukman Anwar.

Funding

Universitas Gadjah Mada.

Disclosure

All authors have declared no conflicts of interest.