Most new melanoma cases are diagnosed at early stages, 75% and 15% stage I and II, respectively. Standard of care for these patients is excision of the primary tumor then regular follow-ups. While most patients are cured by surgical resection of the primary tumor, some of them will develop metastases decreasing survival from 90% to 20-25%. Thus, there is a need to accurately identify patients with high risk of developing metastases.
Today, prognosis and risk of recurrence are estimated based on the primary tumor characteristics and for presence of sentinel lymph node metastases which is often unreliable. Indeed, up to 21% of patients with tumor-negative lymph node will develop metastases, and up to 50% of tumor-positive lymph node patients will not. As a result, early-stage melanoma patients require expensive life-long follow-up and suffer the anxiety and costs of repeated physician visits. Thus, there is a need to develop accurate individual prognostic tools.