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Melanoma survival in the United States, 1992 to 2005 - 20/10/11

Doi : 10.1016/j.jaad.2011.05.030 
Lori A. Pollack, MD, MPH a, Jun Li, MD, PhD, MPH a, , Zahava Berkowitz, MSPH, MSc a, Hannah K. Weir, PhD a, Xiao-Cheng Wu, MD, MPH b, Umed A. Ajani, MBBS, MPH a, Donatus U. Ekwueme, PhD a, Chunyu Li, MD, PhD a, Brian P. Pollack, MD, PhD c, d
a Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 
b Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana 
c Departments of Dermatology and Pathology/Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia 
d Atlanta Department of Veterans Affairs Medical Center, Decatur, Georgia 

Reprint requests: Jun Li, MD, PhD, MPH, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K-55, Atlanta, GA 30341.

Abstract

Background

Population-based data on melanoma survival are important for understanding the impact of demographic and clinical factors on prognosis.

Objective

We describe melanoma survival by age, sex, race/ethnicity, stage, depth, histology, and site.

Methods

Using Surveillance, Epidemiology, and End Results data, we calculated unadjusted cause-specific survival up to 10 years from diagnosis for 68,495 first primary cases of melanoma diagnosed from 1992 to 2005. Cox multivariate analysis was performed for 5-year survival. Data from 1992 to 2001 were divided into 3 time periods to compare stage distribution and differences in stage-specific 5-year survival over time.

Results

Melanomas that had metastasized (distant stage) or were thicker than 4.00 mm had a poor prognosis (5-year survival: 15.7% and 56.6%). The 5-year survival for men was 86.8% and for persons given the diagnosis at age 65 years or older was 83.2%, varying by stage at diagnosis. Scalp/neck melanoma had lower 5-year survival (82.6%) than other anatomic sites; unspecified/overlapping lesions had the least favorable prognosis (41.5%). Nodular and acral lentiginous melanomas had the poorest 5-year survival among histologic subtypes (69.4% and 81.2%, respectively). Survival differences by race/ethnicity were observed in the unadjusted survival, but nonsignificant in the multivariate analysis. Overall 5-year melanoma survival increased from 87.7% to 90.1% for melanomas diagnosed in 1992 through 1995 compared with 1999 through 2001, and this change was not clearly associated with a shift toward localized diagnosis.

Limitations

Prognostic factors included in revised melanoma staging guidelines were not available for all study years and were not examined.

Conclusions

Poorer survival from melanoma was observed among those given the diagnosis at late stage and older age. Improvements in survival over time have been minimal. Although newly available therapies may impact survival, prevention and early detection are relevant to melanoma-specific survival.

Le texte complet de cet article est disponible en PDF.

Key words : anatomic sites, cancer registry, histology, melanoma, survival

Abbreviations used : AJCC, CI, HR, MSS, SEER, SES, SLNB


Plan


 Publication of this supplement to the JAAD was supported by the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC).
 Conflicts of interest: None declared.
 The opinions or views expressed in this supplement are those of the authors and do not necessarily reflect the opinions, recommendations, or official position of the journal editors or the Centers for Disease Control and Prevention.


© 2011  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 65 - N° 5S1

P. S78.e1-S78.e10 - novembre 2011 Retour au numéro
Article précédent Article précédent
  • Subsequent primary cancers among men and women with in situ and invasive melanoma of the skin
  • Appathurai Balamurugan, Judy R. Rees, Carol Kosary, Sun Hee Rim, Jun Li, Sherri L. Stewart
| Article suivant Article suivant
  • Reducing mortality in individuals at high risk for advanced melanoma through education and screening
  • Alan C. Geller, Susan M. Swetter, Susan Oliveria, Stephen Dusza, Allan C. Halpern

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