Prognostic features and clinical panthological factors of cutaneous malignant melanoma.

Abstract

e21589 Background: Cutaneous malignant melanoma (CMM), a skin-originating subtype of melanoma, is highly invasive with strong metastatic potential. Acral melanoma, a distinct subtype, primarily affects distal limbs. This study aims to analyze the clinicopathological data of CMM patients to explore how these features influence prognosis, aiding clinical decision-making and therapeutic strategies. Methods: We retrospectively analyzed data from 92 CMM patients treated at the Fourth Hospital of Hebei Medical University between January 1, 2013, and June 30, 2024. Key variables included gender, age, metastasis, lymph node involvement, surgery, treatment, and genetic testing. Statistical analyses used SPSS 27.0, with survival curves generated by the Kaplan-Meier method and multivariate analysis through Cox regression. Results: Of the 135 patients initially identified, 92 with complete data were analyzed. At the last follow-up (July 15, 2024), 34 (37.0%) patients had died. The cohort included 53 males (57.6%) and 39 females (42.4%), with 65 (70.7%) under 65 years of age. Five patients (5.4%) had organ metastases, and 21 (22.8%) had lymph node involvement at diagnosis. Most (87.0%) underwent surgery, and 32.5% received adjuvant therapy. Genetic testing was performed on 22 patients, revealing mutations in BRAF (15.2%), NRAS (3.3%), and co-mutation in BRAF/TP53 (1.1%). Survival analysis showed a median overall survival (OS) of 55.6 months. One-year, three-year, and five-year survival rates were 68%, 59%, and 44%, respectively. Univariate analysis identified organ metastasis, lymph node metastasis, lack of surgery at diagnosis, and advanced tumor staging as significant predictors of poorer OS. Multivariate analysis confirmed that baseline organ metastasis (HR 0.20, 95% CI 0.05-0.81, P = 0.023) independently predicted worse OS, with advanced tumor stages showing a trend towards poor survival (HR 1.57, 95% CI 0.95-2.51). Conclusions: The 5-year survival rate for CMM was 44%, with organ metastasis and advanced tumor stage being significant predictors of poor prognosis. These findings underscore the importance of early detection and standardization of treatment strategies. However, further improvements in treatment protocols and patient data collection are needed to optimize clinical outcomes.