{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:11:14Z","timestamp":1787015474241,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,12,18]],"date-time":"2019-12-18T00:00:00Z","timestamp":1576627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>It is known that melanoma can metastasize and recur many years after the first diagnosis. Although predictive and prognostic factors for melanoma are well defined, there is still insufficient information about the factors affecting the recurrence period and the effect of the recurrence time to survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study investigates the course of melanoma to show prognostic factors comparing early and late recurrence patients. The main objective is to uncover the effect of the recurrence time on the progression of the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective study, late recurrence (\n                      <jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>\n                      ) was defined as melanoma recurrence 10\u00a0years after the first diagnosis and early recurrence (\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      ) was defined as recurrence within 10\u00a0years. Gender, age, localization of primary tumour, time to first metastasis, survival rates, histological subtype, stage, tumour thickness, invasion level, ulceration and regression of the primary melanoma were documented. Survival curves were evaluated using the Kaplan\u2013Meier and compared with the log\u2010rank test. Multivariate Cox proportional hazard models were used to identify significant independent prognostic factors for melanoma\u2010specific survival (\n                      <jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1537 melanoma patients were analysed. Early metastasis was developed in 1438 patients (93.6%), and 99 patients (6.4%) developed late metastasis. Late recurrence patients were younger (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and had fewer ulcerated (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.005), fewer head\/neck localized (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.009) and thinner (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) melanomas than\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      patients. The\n                      <jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content>\n                      time (mean\u00a0\u00b1\u00a0\n                      <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\n                      ) was nearly identical for\n                      <jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>\n                      (31\u00a0\u00b1\u00a04.4\u00a0months 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      [22.3\u201339.7]) and\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      (32\u00a0\u00b1\u00a01.9\u00a0months [28.3\u201335.7]). Multivariate regression analysis revealed male gender (hazard ratio [\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.4,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), truncal tumour localization (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.7,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), tumour thickness (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.4,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.045) and ulceration (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      \u00a0=\u00a01.3,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.008) as significant independent prognostic factors for\n                      <jats:styled-content style=\"fixed-case\">MSS<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Although\n                      <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">LR<\/jats:styled-content>\n                      patients are found to have different clinicopathologic features, the time of the first recurrence after diagnosis do not seem to have an effect on the survival.\n                    <\/jats:p>\n                  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