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Gender differences in pediatric and adolescent melanoma: A retrospective analysis of 4645 cases - 11/01/24

Doi : 10.1016/j.jaad.2023.09.049 
Jennifer M. Fernandez, MD, RD a, Jenna E. Koblinski, MD b, Sabrina Dahak, MD, MS c, Clara Curiel-Lewandrowski, MD d, Rebecca Thiede, MD d, ⁎
a Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska 
b Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia 
c Department of Medicine, University of Arizona College of Medicine – Phoenix, Phoenix, Arizona 
d Division of Dermatology, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, Arizona 

∗Correspondence to: Rebecca Thiede, MD, Division of Dermatology, Department of Medicine, University of Arizona College of Medicine – Tucson, 7165 N Pima Canyon Dr, Tucson, AZ 85718.Division of DermatologyDepartment of MedicineUniversity of Arizona College of Medicine – Tucson7165 N Pima Canyon DrTucsonAZ85718

Abstract

Background

There is paucity of data on how gender impacts melanoma prognosis in pediatric and adolescent patients.

Objectives

This study explores gender differences in presentation and survival among pediatric and adolescent patients with melanoma.

Methods

The National Cancer Database 2004-2018 was queried for cases of primary invasive cutaneous melanoma in pediatric and adolescent patients (birth to 21 years) for a retrospective cohort study.

Results

Of the 4645 cases, 63.4% were female. Median Breslow depth was 1.05 mm for males (interquartile range 0.50-2.31) and 0.80 mm for females (interquartile range 0.40-1.67; P < .001). Trunk was the most common primary site for females (34.3%) and males (32.9%). More females than males were diagnosed with stage I disease (67.8% vs 53.6%). Males had higher rates of regional lymph node positivity (27.9% vs 18.1%; P < .001) and ulceration (17.1% vs 11.4%; P < .001). Five-year overall survival was 95.9% for females and 92.0% for males (P < .001). After adjusting for confounders, male gender independently increased mortality risk (reference: females; adjusted hazard ratio 1.57; 95% confidence interval 1.32-1.86).

Limitations

Retrospective study.

Conclusion

Males exhibited more aggressive pathologic features including greater Breslow thickness and higher ulceration and lymph node positivity rates. Male gender independently increased mortality risk.

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Key words : adolescent, children, female, gender, male, malignancy, melanoma, National Cancer Database, pediatric, sex, skin cancer, survival

Abbreviations used : aHR, CDC, CI, NCDB, OS


Mappa


 Funding sources: None.
 Patient consent: Not applicable.
 IRB approval status: The Office of Regulatory Affairs at University of Nebraska Medical Center determined this project does not constitute human subject research as defined at 45CFR46.102. Therefore, it is not subject to federal regulations and does not require Institutional Review Board review.


© 2023  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 90 - N° 2

P. 280-287 - febbraio 2024 Ritorno al numero
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