The role of prognostic factors and inflammatory markers in identifying lymph node metastases of cutaneous malignant melanoma

Purpose: Malignant melanomas have poor prognosis and comprise a significant part of skin cancer-related mortality. Lymph node metastases significantly reduce survival independent of other factors. This study sought to identify factors associated with lymphatic metastasis in patients with cutaneous malignant melanoma (CMM). Materials and Methods: Histopathological and clinical prognostic factors, tumor location, inflammatory markers, and Tumor Volume Index (TVI = Breslow thickness × tumor size) were examined in patients operated for CMM in a university hospital between 2012 and 2025. Results: The study included a total of 56 patients with CMM, 50% (n=28) of whom were female. Of the 33 patients (58.9%) who underwent lymph node sampling, metastasis was detected in 34.4% (n=11). Among patients with lymph node metastasis, CMM was located more frequently in the lower extremities and less frequently in the trunk/upper extremities compared to those without lymph node metastasis. A platelet-to-lymphocyte ratio (PLR) cut-off value of 127 was statistically significant in the prediction of lymph node metastasis risk. A PLR of 127 or higher was associated with 5.3 times higher odds of detecting lymph node metastasis. However, TVI ≥27 was an independent risk factor associated with 11.1 times higher odds of lymph node metastasis (95% CI: 1.123-109.494). Conclusion: When the Breslow thickness is multiplied by the tumor's largest measured diameter, a TVI value greater than 27 has been found to be an independent risk factor for the development of lymph node metastasis.