{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:40:40Z","timestamp":1791819640286,"version":"4.3.4"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>In patients with melanoma, in-transit metastasis (ITM) can develop. This study aimed to identify the risk for a first recurrence of ITM and associated predictive clinical factors in a large international cohort of patients with melanoma.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Patients with primary cutaneous melanoma who underwent wide local excision (WLE) and sentinel lymph node biopsy (SLNB) were identified from the Sentinel Lymph Node Working Group (SLNWG) database between January 1993 and February 2023. Predictive factors for first recurrence of ITM were analyzed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The study enrolled 7860 patients, and the median follow-up time was 47.1 months (interquartile range [IQR], 19.0\u201395.0 months). The risk for the development of ITM as a first recurrence was 4.12% (95% confidence interval [CI], 3.63\u20134.66%) at 5 years. The median time to first ITM recurrence was 15 months (IQR, 7.0\u201330.0 months). Significant clinicopathologic factors independently associated with an increased risk of ITM in multivariable analysis were increasing Breslow thickness (hazard ratio [HR], 1.37; 95% CI, 1.30\u20131.43; <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.0001), lower-extremity versus trunk melanoma (HR, 2.49; 95% CI, 1.86\u20133.32; <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.0001), increasing age (HR, 1.03; 95% CI, 1.02\u20131.04; <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.0001), number of positive sentinel lymph nodes (SLNs: 1 vs. 0 [HR, 2.24; 95% CI, 1.66\u20133.01; <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.0001] and 2 vs. 0 [HR, 2.37; 95% CI, 1.45\u20133.88; <jats:italic>p<\/jats:italic> = 0.0006]), and presence of vascular invasion (HR, 1.79; 95% CI, 1.21\u20132.64; <jats:italic>p<\/jats:italic> = 0.0035).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The independent risk factors for the development of ITM identified in a large international cohort of melanoma patients were Breslow thickness, lower-extremity melanoma, older age, number of positive SLNs, and presence of vascular invasion.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1245\/s10434-025-17084-4","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T20:01:41Z","timestamp":1741636901000},"page":"3203-3211","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Identification of Predictive Factors for the Development of In-Transit Metastasis in Patients with Melanoma"],"prefix":"10.1245","volume":"32","author":[{"given":"Anne","family":"Huibers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley P.","family":"Leong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Kashani-Sabet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Richard L.","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Vetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Schlomo","family":"Schneebaum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"O\u2019Donoghue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrison","family":"Howard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Avisar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukes P.","family":"Namm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Kosiorek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Faries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgos","family":"Karakousis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan S.","family":"Zager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Olofsson Bagge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Sentinel Lymph Node Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"17084_CR1","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1001\/jamadermatol.2022.0160","volume":"158","author":"M Arnold","year":"2022","unstructured":"Arnold M, Singh D, Laversanne M, et al. Global burden of cutaneous melanoma in 2020 and projections to 2040. JAMA Dermatol. 2022;158:495\u2013503.","journal-title":"JAMA Dermatol."},{"key":"17084_CR2","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1245\/ASO.2005.05.025","volume":"12","author":"TM Pawlik","year":"2005","unstructured":"Pawlik TM, Ross MI, Johnson MM, et al. Predictors and natural history of in-transit melanoma after sentinel lymphadenectomy. Ann Surg Oncol. 2005;12:587\u201396.","journal-title":"Ann Surg Oncol."},{"key":"17084_CR3","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1245\/s10434-014-4100-0","volume":"22","author":"RL Read","year":"2015","unstructured":"Read RL, Haydu L, Saw RP, et al. In-transit melanoma metastases: incidence, prognosis, and the role of lymphadenectomy. 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The efficacy of immune checkpoint blockade for melanoma in-transit with or without nodal metastases: a multicenter cohort study. Eur J Cancer. 2022;169:210\u201322.","journal-title":"Eur J Cancer."},{"issue":"4","key":"17084_CR7","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s10585-023-10234-6","volume":"41","author":"A Huibers","year":"2023","unstructured":"Huibers A, DePalo DK, Perez MC, Zager JS, OlofssonBagge R. Isolated hyperthermic perfusions for cutaneous melanoma in-transit metastasis of the limb and uveal melanoma metastasis to the liver. Clin Exp Metastasis. 2023;41(4):447\u201356.","journal-title":"Clin Exp Metastasis."},{"key":"17084_CR8","doi-asserted-by":"crossref","DOI":"10.1002\/cncr.35636","volume":"131","author":"DK DePalo","year":"2025","unstructured":"DePalo DK, Dugan MM, Naqvi SMH, et al. A comparison of isolated limb infusion\/perfusion, immune checkpoint inhibitors, and intralesional therapy as first-line treatment for patients with melanoma in-transit metastases. Cancer. 2025;131:e35636.","journal-title":"Cancer."},{"key":"17084_CR9","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-025-16945-2","author":"N Riaz","year":"2025","unstructured":"Riaz N, Huibers A, Leong SP, et al. Prognostic value of nevus-associated melanoma in patients with melanoma. Ann Surg Oncol. 2025. https:\/\/doi.org\/10.1245\/s10434-025-16945-2.","journal-title":"Ann Surg Oncol"},{"key":"17084_CR10","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1111\/ijd.16141","volume":"61","author":"JW Jakub","year":"2022","unstructured":"Jakub JW, Weaver AL, Meves A. Association of tumor molecular factors with in-transit metastasis in primary cutaneous melanoma. 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John Vetto is a speaker for Castle Biosciences. Mark Faries is on advisory boards for Bristol Myers Squibb, Merck, Regeneron, and Replimune. Giorgos Karakousis is on advisory boards of Merck, Bristol-Myers Squibb, Merck for institutional research support. Roger Olofsson Bagge has received institutional research grants from Bristol-Myers Squibb (BMS), Endomagnetics Ltd (Endomag), SkyLineDx, and NeraCare GmbH, as well as speaker honoraria from Roche, Pfizer, and Pierre-Fabre, has served on advisory boards for Amgen, BD\/BARD, Bristol-Myers Squibb (BMS), Merck Sharp & Dohme (MSD), Novartis, Roche, and Sanofi Genzyme, and is a shareholder in SATMEG Ventures A. The remaining authors have no conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}