Regression Predicts Favorable Outcomes in Stage 1 and 2 Cutaneous Melanoma

Histologic regression is predictive of a favorable outcome in patients with stage 1 and 2 cutaneous melanoma, according to study data published in JAMA Dermatology.

The study included registry data from 17,271 patients from the Netherlands and 4980 patients from Australia with histologically proven stage 1 and 2 primary invasive cutaneous melanoma who were stratified for regression. All patients were treated between 2000 and 2014.

The median follow-up durations for the Dutch and Australian cohorts were 4.5 and 11.1 years, respectively. Primary outcomes of the analysis included recurrence-free survival and overall survival.

In the Dutch cohort, the hazard ratios (HRs) were 0.55 (95% CI, 0.48-0.63; P <.001) for recurrence-free survival and 0.87 (95% CI, 0.79-0.96; P =.004) for overall survival. In the Australian cohort, the HRs were 0.61 (95% CI, 0.52-0.72; P <.001) for recurrence-free survival and 0.73 (95% CI, 0.64-0.84; P <.001) for overall survival.

The presence of regression was associated with better overall survival in Australian patients with thin melanomas (HR, 0.66; 95% CI, 0.50-0.88; P =.004).

In Dutch patients with superficial spreading melanoma (SSM) subtype and regression, the HRs were 0.54 (95% CI, 0.46-0.63; P <.001) for recurrence-free survival and 0.86 (95% CI, 0.76-0.96; P =.009) for overall survival. In the Australian patients with SSM and regression, the HRs were 0.67 (95% CI, 0.52-0.85; P =.001) for recurrence-free survival and 0.72 (95% CI, 0.59-0.88; P =.001) for overall survival.

Limitations of this study were the lack of sentinel node biopsies for some patients as well as the lack of data on whether patients were treated with immunotherapy.

Based on these data, the investigators concluded that these findings “indicate that regression can be considered a favorable prognostic factor for patients with stage 1 and stage 2 melanomas.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

El Sharouni MA, Aivazian K, Witkamp AJ, et al. Association of histologic regression with a favorable outcome in patients with stage 1 and stage 2 cutaneous melanoma. JAMA Dermatol. 2021;157(2):166-173. doi:10.1001/jamadermatol.2020.5032