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A population-based registry study on relative survival from melanoma in Germany stratified by tumor thickness for each histologic subtype - 14/03/19

Doi : 10.1016/j.jaad.2018.09.018 
Alicia Brunssen, MA a, , Lina Jansen, PhD b, Nora Eisemann, PhD a, Annika Waldmann, PhD a, c, Janick Weberpals, RPh b, Klaus Kraywinkel, MD d, Andrea Eberle, PhD e, Bernd Holleczek, PhD f, Sylke Ruth Zeissig, MD g, Hermann Brenner, MD b, h, i, j, Alexander Katalinic, MD a, k
for the

GEKID Cancer Survival Working Group

Karla Geiss, Martin Meyer, Sabine Luttmann, Roland Stabenow, Stefan Hentschel, Alice Nennecke, Joachim Kieschke, Eunice Sirri, Katharina Emrich, Hiltraud Kajüter, Volkmar Mattauch

a Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany 
k Institute for Cancer Epidemiology, University of Lübeck, Lübeck, Germany 
b Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany 
h Division of Preventive Oncology, German Cancer Research Center, Heidelberg, Germany 
j German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany 
c Hamburg Cancer Registry, Ministry for Health and Consumer Protection, Hamburg, Germany 
d German Centre for Cancer Registry Data, Robert Koch Institute, Berlin, Germany 
e Cancer Registry of Bremen, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany 
f Saarland Cancer Registry, Saarbruecken, Germany 
g Cancer Registry of Rhineland-Palatinate, Mainz, Germany 
i National Center for Tumor Diseases, Heidelberg, Germany 

Reprint requests: Alicia Brunssen, MA, Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany.Institute for Social Medicine and EpidemiologyUniversity of LübeckRatzeburger Allee 160Lübeck23562Germany

Abstract

Background

Differences in relative survival (RS) of melanoma between histologic subtypes were discussed to be mainly caused by tumor thickness.

Objective

To investigate RS of melanoma, stratified by tumor thickness for each histologic subtype, and identify survival trends.

Methods

With use of cancer registry data on melanoma cases (International Classification of Diseases, 10th Revision, codes C43.0–C43.9) diagnosed in Germany in 1997–2013, 5- and 10-year age-standardized RS stratified by histologic subtype and stratified or standardized by T stage was estimated by standard and modeled period analyses. We restricted 10-year RS analyses to patients younger than 75 years.

Results

We analyzed 82,901 cases. Overall, the 5- and 10-year RS rates were 91.7% and 90.8%, respectively. Prognosis worsened with increasing T stage for all histologic subtypes, but T-stage distribution varied substantially. Survival differences by histologic subtype were strongly alleviated after adjustment for T stage but remained significant. Overall, 5-year RS increased significantly (by 3.8 percentage points) between the periods 2002–2005 and 2010–2013. This increase was no longer seen after adjustment for T stage.

Limitations

Exclusion of cases on account of missing information on T stages, changes in the definition of T stages, and lack of information on screening and treatment limit our analyses.

Conclusion

Differences in RS between histologic subtypes were strongly mediated by tumor thickness. Over time, RS of melanoma increased as a result of changes in T-stage distribution.

Le texte complet de cet article est disponible en PDF.

Key words : histologic subtype, histology, melanoma, prognosis, prognostic factor, relative survival, stage, T stage, trend, tumor thickness

Abbreviations used : ALM, DCO, LMM, NM, RS, SE, SSM, TNM


Plan


 Funding sources: Supported by German Cancer Aid (Deutsche Krebshilfe) (grants 10825 and 110446).
 Conflicts of interest: None disclosed.
 The study outline was presented in a poster presentation at the annual conference of the German Society for Epidemiology in Munich, Germany, on September 2, 2016. Recent trends in relative survival of melanoma in Germany stratified by age group, T stage, and histologic subtype were presented at the annual conference of the German Society for Epidemiology in Lübeck, Germany, on September 7, 2017, and at the annual conference of the International Association of Cancer Registries in Utrecht, The Netherlands, on October 17, 2017.


© 2018  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 80 - N° 4

P. 938-946 - avril 2019 Retour au numéro
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