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

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.