Pathologic features predict rapid recurrence in T1 melanoma patients across 14 sites.

This observational study examined clinical and pathological characteristics of 442 patients with T1 melanoma recruited from 14 sites. The analysis compared patients with rapid recurrence against a comparator group with late recurrence (defined as recurrence >=10 years) to identify associated risk factors. No intervention was applied as this was a retrospective comparison of existing patient data.

Significant positive associations were identified for several variables. Age greater than 65 years showed a strong association with rapid recurrence (p<0.0001 univariable; p=0.0010 multivariable). The lentigo maligna subtype was significantly associated with rapid recurrence (p=0.025 univariable). Primary tumors located on the head or neck also demonstrated a significant association (p=0.0065 univariable). Histological features including mitoses >=1/mm2 (p=0.0181 univariable; p=0.049 multivariable) and ulceration (p=0.0087 univariable; p=0.037 multivariable) were linked to rapid recurrence.

Regarding recurrence patterns, the majority (73%) of recurrences in the rapid group were locoregional. No safety data, adverse events, or discontinuations were reported, as no treatment intervention was evaluated. The study explicitly notes that causality is not claimed and that these findings describe associations using logistic regression analysis.

Key limitations include the observational nature of the design, which precludes causal inference. The clinical significance of these surrogate markers without direct clinical outcome data should not be overstated. These findings may assist in identifying high-risk T1 melanomas but require validation in prospective cohorts before altering management guidelines.