ArticleJAMA dermatology2019
Risk Factors for Lymphatic and Hematogenous Dissemination in Patients With Stages I to II Cutaneous Melanoma.
Article in JAMA dermatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Pooled it
- Acral lentiginous melanoma metastases to the vitreous masquerading as uveitis: A case report.American journal of ophthalmology case reports · 2026Article
- Systemic treatment for a young patient with stage IV melanoma: A case report.Oncology letters · 2026Article
- A Case of Malignant Melanoma Metastasis in the Ileal Conduit.IJU case reports · 2025Article
- Iridophoroma in Leopard Geckos (Eublepharis macularius): Clinical Complications and Histopathology.Journal of the American Association for Laboratory Animal Science : JAALAS · 2025Article
- Case report of an omental metastasis of melanoma in a patient with abdominal pain.International journal of surgery case reports · 2025Article
- Acyl-CoA synthetase long-chain family member 4-A novel prognostic marker in cutaneous melanoma.Frontiers in medicine · 2025Article
- Cancer metastasis to the upper gastrointestinal tract-a case series.Journal of gastrointestinal oncology · 2024Article
- Metabolic insights into tumor lymph node metastasis in melanoma.Cellular oncology (Dordrecht, Netherlands) · 2024Review
- Utility and Micro-Costing Framework forDiagnostics (Basel, Switzerland) · 2024Article
- Pathogenic mechanisms and etiologic aspects ofMedComm - Oncology · 2024Article
- Topographical and Chronological Analysis of Thin Cutaneous Melanoma's Progressions: A Multicentric Study.Cancers · 2023Article
- TERT Promoter Mutations and Telomerase in Melanoma.Journal of oncology · 2022Review
- Mutational Characterization of Cutaneous Melanoma Supports Divergent Pathways Model for Melanoma Development.Cancers · 2021Article
- Risk factors for positive sentinel lymph node, lymphatic or hematogenous dissemination over time in patients with cutaneous melanoma.Experimental and therapeutic medicine · 2021Article
- Diverse roles of epidermal growth factors receptors in oral and cutaneous canine melanomas.BMC veterinary research · 2020Article
- Prognostic gene expression profiling in melanoma: necessary steps to incorporate into clinical practice.Melanoma management · 2019Review
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: The lymphatic and the hematogenous pathways have been proposed for disease progression in cutaneous melanoma, but association with recurrence has not been studied separately to date. Objective: To identify the risk factors associated with lymphatic and hematogenous metastasis. Design, Setting, and Participants: This retrospective cohort study included 1177 patients with malignant melanoma treated at Instituto Valenciano de Oncología, València, Spain. Data were retrieved from the melanoma database from January 1, 2000, through December 31, 2015, and analyzed from June 1 to 30, 2018. Exposure: Malignant melanoma at stages I to II. Main Outcomes and Measures: Analyses of survival free of lymphatic and hematogenous metastasis were performed using Kaplan-Meier curves and Cox proportional hazards regression. Results: For the 1177 patients included in the study analysis (51.1% women; median age at diagnosis, 55 years [interquartile range, 42-68 years), median follow-up was 75 months (interquartile range, 33-121 months); 108 (9.2%) developed lymphatic metastasis, and 108 (9.2%) developed hematogenous metastasis. In the multivariate analysis, being older than 55 years (hazard ratio [HR], 1.9; 95% CI, 1.2-3.1), tumor in the head/neck (HR, 1.7; 95% CI, 1.0-2.9) and acral locations (HR, 2.4; 95% CI, 1.3-4.5), greater Breslow thickness (HR for >4.00 mm, 5.4; 95% CI, 2.4-12.4), and presence of vascular invasion (HR, 3.2; 95% CI, 0.9-10.6) were associated with lymphatic spreading. Hematogenous metastasis was associated with greater Breslow thickness (HR for >4.00 mm, 10.4; 95% CI, 3.6-29.7), the absence of regression (HR, 0.1; 95% CI, 0.0-1.0), TERT promoter mutations (HR, 2.9; 95% CI, 1.5-5.7), and BRAF mutations (HR, 1.9; 95% CI, 1.1-3.6). Conclusions and Relevance: Risk factors associated with lymphatic and hematogenous metastasis differ. Follow-up and adjuvant treatment strategies may therefore need to be adapted to individual clinical, histopathologic, and molecular characteristics.
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