e14023 Background: Melanoma is ranked 5th commonest malignancy in United States and SEER has projected 3,290 new skin melanoma cases in Michigan in 2020. Diagnosis of recurrent & metastatic melanoma has associated with poor prognosis and survival. Henry Ford Cancer Institute (HFCI) is a tertiary cancer care facility serves cancer patients from communities throughout metropolitan Detroit tri-county areas where a higher melanoma presentation (1.56%) in black pts than this group at national database (0.6%). A subgroup of white Michiganders travel to Southern sunshine states in winter months known as “snowbirds” have contributed to melanoma incidences in Michigan. We aim to review our institute tumor registry data to analyze the clinicopathological features, care pattern and correlated survival outcomes. Methods: We have identified adult melanoma pts through institute tumor registry between 2007 – 2017, who had demographics, initial diagnosis, recurrence, then death or last follow-up for overall survival (OS) outcome. Data were analyzed using IBM SPSS, R-statistical and log-rank test. Results: Of 1327 eligible pts, median age was 63, and 874 (65.86%) pts were invasive at onset diagnosis. 1298 (97.81%) pts were white, 23 (1.73%) pts were black. Slightly more females (55.54%) over males and overall 301 deaths (22.68%) were observed. 1277 pts with cutaneous melanoma had better 5- and 10-year (yr) OS at 78.14%, and 68.32% compared to 50 (3.77%) non-cutaneous pts at 13.31% and 8.87%, respectively. Black pts carried a poor 5-yr OS at 34.68% vs white at 76.4%. 116 (17.9%) pts presented with recurrences, had 5-yr OS at 34.58%. Of 121 (9.1%) pts who never had been disease-free, showed worse 5-yr OS at 15.87%, with trend of improvement since FDA-approval of immune checkpoint inhibitor therapies. Conclusions: We have analyzed our melanoma care pattern, experience and survival outcomes at 5-yr and/or 10-yr from a tertiary community cancer care facility. We have assessed our current practice benchmarks with plan to improve our care delivery by having built a multidisciplinary team, and launched Melanoma & Skin Cancer Clinical Care Pathway through Tumor Board to improve care access, to decrease care disparity, then to standardize quality of care including encouraging clinical trial enrollments which will enhance quality of melanoma care and survival outcomes of advanced and metastatic cases.