Abstract:
Background: Recent data suggest that a subset of early stage
melanoma patients may benefit from adjuvant immunotherapy.
Objective: To identify findings in biopsy or surgical pathology
reports associated with poor prognosis in patients diagnosed with stage
I and II cutaneous melanoma.
Methods: This was a retrospective cohort study of 68 stage I
and II cutaneous melanoma patients treated at our institution from 2010
to 2022. Inclusion criteria were patients with stage I or II melanoma
with both a biopsy and surgical pathology report. The primary outcome of
the study was the prognostic value of biopsy findings on progression
free survival (PFS). Kaplan-Meier and Cox-proportional hazards models
were used to evaluate risk factors for progression.
Results: Patients with ulceration on biopsy had a 16.1x greater
risk of progression than those without ulceration [HR 16.1, 95% CI:
2.60-99.5]. Patients with absent lymphocytes on biopsy had a 9.5x
greater risk of progressing compared to those with lymphocytes present
[HR 9.45, 95% CI: 1.99-44.8]. Ulceration or absent TILs were
associated with significantly worse
PFS.
Conclusions: Ulceration and absence of TILs on biopsy are
associated with increased risk of progression in stage I and II melanoma
patients.