Loco-regional renewal of malignant melanomas. I. Local recurrence satellites and in-transit nodes.

183 patients with malignant melanoma treated during the period 1972-1987 were studied for the incidence of loco-regional metastasis. All cases were followed up for 5 years following initial treatment. In the "high risk" groups of patients--the setting being based on well-known prognosticators such as tumour invasion, thickness, clinicopathological type and anatomic site--there were significantly more recurrences (p < 0.01) than in the patients with thin lesions. About 91 per cent of the recurrences--except pure model ones to be discussed in an other paper--were discovered within 30 months following tumour excision. Wide excision in itself had no effect upon frequency and incidence of loco-regional renewal. While local recidivae were sufficiently controlled by simple re-excision, most of the "in-transit" metastases need an additional regional lymph node dissection because of the increased rate of micrometastases in the lymph nodes. Survival and treatment modalities are also discussed.