Risk factors for visceral metastases in cutaneous melanoma: insights from a clinical cohort

Introduction : Cutaneous melanoma, a malignancy originating from melanocytes, is characterized by a high propensity for metastatic spread. It commonly affects the lungs, liver, brain, lymph nodes, and skin. Aim : This study examines a cohort of cutaneous melanoma patients diagnosed with metastatic disease at our institution, aiming to identify patterns and risk factors associated with metastatic spread. Materials and methods : A retrospective analysis was conducted on 49 patients treated for cutaneous melanoma in our plastic surgery ward between 2017 and 2022 who subsequently developed metastatic disease. Results : Over six years, 49 of 130 melanoma cases progressed to metastases. T4 lesions predominated (55.1%). Metastases involved multiple organs in 42.9% of cases. Males had more advanced disease compared to women, with a higher mean Breslow Index, higher ulceration rates, greater metastatic burden. Despite being a visible tumor, cutaneous melanoma can remain undetected until advanced stages, emphasizing the need for public awareness and early screening. Our study confirms that even thin melanomas (<1 mm) can metastasize, particularly to the lungs, challenging the assumption that low Breslow index ensures favorable prognosis. The high incidence of multiorgan involvement, especially in male and nodular melanoma patients, highlights the aggressive nature of certain subtypes and the importance of personalized follow-up strategies. Conclusions : Male patients demonstrated more aggressive disease patterns, highlighting the need for early detection and tailored management. Subtype-specific metastatic patterns warrant further investigation to improve prognostic and therapeutic strategies.