Clinicopathologic analysis of overall survival rates and relation with pigmentation in cutaneous melanoma in Türkiye in a low-risk population

Abstract Background Melanoma poses significant risks, and several critical factors can dramatically influence the prognosis. Objective The current study aimed to investigate the clinicopathological prognostic factors of melanoma in a country with low incidence rates, primarily among individuals with low-risk cutaneous phototypes. Methods The study analyzed 233 cases of invasive and micro-invasive primary cutaneous melanoma (CM), which were pathologically diagnosed at a tertiary university hospital between January 2008 and March 2020. Results A total of 233 patients were included in the study, comprising 103 females and 130 males. The average age at diagnosis was 57 years, with a median age of 59 years (ranging from 1 to 95 years). The overall survival (OS) rates at 1, 2, 5, and 10 years were 92%, 84%, 70%, and 62%, respectively. Favorable prognostic factors identified included female gender, nevus-associated melanoma, solar elastosis, the presence of tumor-infiltrating lymphocytes (TILs), melanoma thickness of 1 mm or less, regression, and microinvasive melanoma. The WHO pathway subtypes ( p = 0.022), cell types ( p = 0.013), and distant metastases ( p = 0.008) were significantly associated with survival period after 5 years. Histopathological subtype, localization, association with a nevus, pathological tumor stage (pT), lymphovascular invasion (LVI), ulceration, BRAF mutation, Clark level, radial growth phase, skin adnexal involvement, mitotic rate, and regression were associated with pigmentation status of melanoma. Conclusion A Cox multiple regression model indicated that gender, age at diagnosis, TILs, and pathological lymph node (pN) status were independent predictors of overall survival.