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Invasive Cutaneous Melanoma in Elderly Patients

Invasive Cutaneous Melanoma in Elderly Patients Abstract • Clinical and pathologic variables were compared between "older" (≥70 years) and "younger" (30 to 39 years) patients with primary invasive cutaneous melanoma. Older patients had more nodular melanomas and acral lentiginous melanomas (58%); superficial spreading melanomas predominated in younger patients (74%). Mean tumor thickness was greater in the older patients (3.95 vs 2.02 mm). Invasive levels 2 and 3 occurred more often in younger patients (41.1% vs 13%); level 5 occurred more often in older patients (30.4% vs 5.3%). Microscopic ulceration occurred more often in older (46.4%) than in younger patients (19.4%). Older patients classified as clinical stage I at presentation or with primary lesions 1.50- to 3.00-mm thick had poorer survival. Younger women survived longer than younger men; this was not true of older patients. The elderly patients with cutaneous melanoma were more likely to have poor prognostic features and thus more likely to die from melanoma than the younger patients. (Arch Dermatol. 1991;127:1188-1193) References 1. Devesa SS, Silverman DT, Young JL Jr, et al. Cancer incidence and mortality trends among whites in the United States: 1947-1984 . J Natl Cancer Inst. 1987;79:701-770. 2. Hinds MW, Kolonel LN. Malignant melanoma of the skin in Hawaii: 1960-1977 . Cancer . 1980;45:811-817.Crossref 3. Anaise D, Stenitz R, Ben Hur N. Solar radiation: a possible etiological factor in malignant melanoma in Israel. A retrospective study (1960-1972) . Cancer . 1978;49:299-304.Crossref 4. Swerdlow AJ. Incidence of malignant melanoma of the skin in England and Wales and its relationship to sunshine . BMJ . 1979;2:1324-1327.Crossref 5. Magnus K. Prognosis in malignant melanoma of the skin: significance of stage of disease, anatomical site, sex, age, and period of diagnosis . Cancer . 1977;40:389-397.Crossref 6. Gordon LG, Lowry WS. The incidence and pathogenesis of invasive cutaneous malignant melanoma in Northern Ireland . Br J Cancer . 1986;53:75-80.Crossref 7. Teppo L, Pakkanen M, Hakulinen T. Sunlight as a risk factor of malignant melanoma of the skin . Cancer . 1978;41:2018-2027.Crossref 8. Cohen HJ, Cox E, Manton K, Woodbury M. Malignant melanoma in the elderly . J Clin Oncol. 1987;5:100-106. 9. Morris BT, Sober AJ. Cutaneous malignant melanoma in the older patient . Dermatol Clin. 1986;4:473-480. 10. Rivers JK, Kelly MC, Kopf AW, Welkovich B, Bart RS. Age and malignant melanoma: comparison of variables in different age groups . J Am Acad Dermatol. 1989;21:717-722.Crossref 11. Balch CM, Soong S-J, Shaw HM, Milton GW. An analysis of prognostic factors in 4000 patients with cutaneous melanoma . In: Balch CM, Milton GW, Shaw HM, Soong S-J, eds. Cutaneous Melanoma: Clinical Management and Treatment Results Worldwide . Philadelphia, Pa: JB Lippincott; 1985:321-352. 12. Clark, WH, From L, Bernardino EA. The histogenesis and biologic behavior of primary human malignant melanoma of the skin . Cancer Res. 1969;29:705-726. 13. McLeod Gr, Davis NC, Little JH, Green A, Chant D. Melanoma in Queensland, Australia: experience of the Queensland Melanoma Project . In: Balch CM, Milton GW, eds. Cutaneous Melanoma: Clinical Management and Treatment Results Worldwide . Philadelphia, Pa: JB Lippincott; 1985:379-387. 14. Paladugu RR, Winberg CD, Yonemoto RH. Acral lentiginous melanoma: a clinicopathologic study of 36 patients . Cancer . 1983;52:161-168.Crossref 15. Krementz ET, Reed RJ, Coleman WP III, Sutherland CM, Carter RD, Campbell M. Acral lentiginous melanoma: a clinicopathologic entity . Ann Surg. 1982;195:632-645.Crossref 16. Sondergaard K, Olsen G. Malignant melanoma of the foot: a clinicopathologic study of 125 primary cutaneous malignant melanomas . Acta Pathol Microbiol Scand (A) . 1980;88:275. 17. Levine J, Kopf AW, Rigel DS, et al. Correlation of thicknesses of superficial spreading malignant melanomas and age of patients . J Dermatol Surg Oncol. 1981;7:311-316.Crossref 18. Kripke ML. Immunology and photocarcinogensis . J Am Acad Dermatol. 1986;14:149-155.Crossref 19. Walford RL. Immunology and aging . Am J Clin Pathol. 1980;74:247-253. 20. Clark WH Jr, Folberg R, Ainsworth AM. Tumor progression in primary human cutaneous malignant melanomas . In: Clark WH, Goldman LI, Mastrangelo MJ, eds. Human Malignant Melanoma . New York, NY: Grune & Stratton; 1979:15-31. 21. Ackerman AB, Su WPD. The histology of cutaneous malignant melanoma . In: Kopf AW, Bart RS, Rodriguez-Sains RS, Ackerman AB, eds. Malignant Melanoma . New York, NY: Masson Publishing USA Inc; 1979:25-147. 22. Shaw HM, McGovern VJ, Milton GW, Farago GA, McCarthy WH. Malignant melanoma: influence of site of lesion and age of patient in the female superiority in survival . Cancer . 1980;46:2731-2735.Crossref 23. O'Doherty CJ, Prescott RJ, White H, McIntyre M, Hunter JAA. Sex differences in presentation of cutaneous malignant melanoma in survival from stage 1 disease . Cancer . 1986;58:788-792.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Invasive Cutaneous Melanoma in Elderly Patients

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1991.01680070088011
Publisher site
See Article on Publisher Site

Abstract

Abstract • Clinical and pathologic variables were compared between "older" (≥70 years) and "younger" (30 to 39 years) patients with primary invasive cutaneous melanoma. Older patients had more nodular melanomas and acral lentiginous melanomas (58%); superficial spreading melanomas predominated in younger patients (74%). Mean tumor thickness was greater in the older patients (3.95 vs 2.02 mm). Invasive levels 2 and 3 occurred more often in younger patients (41.1% vs 13%); level 5 occurred more often in older patients (30.4% vs 5.3%). Microscopic ulceration occurred more often in older (46.4%) than in younger patients (19.4%). Older patients classified as clinical stage I at presentation or with primary lesions 1.50- to 3.00-mm thick had poorer survival. Younger women survived longer than younger men; this was not true of older patients. The elderly patients with cutaneous melanoma were more likely to have poor prognostic features and thus more likely to die from melanoma than the younger patients. (Arch Dermatol. 1991;127:1188-1193) References 1. Devesa SS, Silverman DT, Young JL Jr, et al. Cancer incidence and mortality trends among whites in the United States: 1947-1984 . J Natl Cancer Inst. 1987;79:701-770. 2. Hinds MW, Kolonel LN. Malignant melanoma of the skin in Hawaii: 1960-1977 . Cancer . 1980;45:811-817.Crossref 3. Anaise D, Stenitz R, Ben Hur N. Solar radiation: a possible etiological factor in malignant melanoma in Israel. A retrospective study (1960-1972) . Cancer . 1978;49:299-304.Crossref 4. Swerdlow AJ. Incidence of malignant melanoma of the skin in England and Wales and its relationship to sunshine . BMJ . 1979;2:1324-1327.Crossref 5. Magnus K. Prognosis in malignant melanoma of the skin: significance of stage of disease, anatomical site, sex, age, and period of diagnosis . Cancer . 1977;40:389-397.Crossref 6. Gordon LG, Lowry WS. The incidence and pathogenesis of invasive cutaneous malignant melanoma in Northern Ireland . Br J Cancer . 1986;53:75-80.Crossref 7. Teppo L, Pakkanen M, Hakulinen T. Sunlight as a risk factor of malignant melanoma of the skin . Cancer . 1978;41:2018-2027.Crossref 8. Cohen HJ, Cox E, Manton K, Woodbury M. Malignant melanoma in the elderly . J Clin Oncol. 1987;5:100-106. 9. Morris BT, Sober AJ. Cutaneous malignant melanoma in the older patient . Dermatol Clin. 1986;4:473-480. 10. Rivers JK, Kelly MC, Kopf AW, Welkovich B, Bart RS. Age and malignant melanoma: comparison of variables in different age groups . J Am Acad Dermatol. 1989;21:717-722.Crossref 11. Balch CM, Soong S-J, Shaw HM, Milton GW. An analysis of prognostic factors in 4000 patients with cutaneous melanoma . In: Balch CM, Milton GW, Shaw HM, Soong S-J, eds. Cutaneous Melanoma: Clinical Management and Treatment Results Worldwide . Philadelphia, Pa: JB Lippincott; 1985:321-352. 12. Clark, WH, From L, Bernardino EA. The histogenesis and biologic behavior of primary human malignant melanoma of the skin . Cancer Res. 1969;29:705-726. 13. McLeod Gr, Davis NC, Little JH, Green A, Chant D. Melanoma in Queensland, Australia: experience of the Queensland Melanoma Project . In: Balch CM, Milton GW, eds. Cutaneous Melanoma: Clinical Management and Treatment Results Worldwide . Philadelphia, Pa: JB Lippincott; 1985:379-387. 14. Paladugu RR, Winberg CD, Yonemoto RH. Acral lentiginous melanoma: a clinicopathologic study of 36 patients . Cancer . 1983;52:161-168.Crossref 15. Krementz ET, Reed RJ, Coleman WP III, Sutherland CM, Carter RD, Campbell M. Acral lentiginous melanoma: a clinicopathologic entity . Ann Surg. 1982;195:632-645.Crossref 16. Sondergaard K, Olsen G. Malignant melanoma of the foot: a clinicopathologic study of 125 primary cutaneous malignant melanomas . Acta Pathol Microbiol Scand (A) . 1980;88:275. 17. Levine J, Kopf AW, Rigel DS, et al. Correlation of thicknesses of superficial spreading malignant melanomas and age of patients . J Dermatol Surg Oncol. 1981;7:311-316.Crossref 18. Kripke ML. Immunology and photocarcinogensis . J Am Acad Dermatol. 1986;14:149-155.Crossref 19. Walford RL. Immunology and aging . Am J Clin Pathol. 1980;74:247-253. 20. Clark WH Jr, Folberg R, Ainsworth AM. Tumor progression in primary human cutaneous malignant melanomas . In: Clark WH, Goldman LI, Mastrangelo MJ, eds. Human Malignant Melanoma . New York, NY: Grune & Stratton; 1979:15-31. 21. Ackerman AB, Su WPD. The histology of cutaneous malignant melanoma . In: Kopf AW, Bart RS, Rodriguez-Sains RS, Ackerman AB, eds. Malignant Melanoma . New York, NY: Masson Publishing USA Inc; 1979:25-147. 22. Shaw HM, McGovern VJ, Milton GW, Farago GA, McCarthy WH. Malignant melanoma: influence of site of lesion and age of patient in the female superiority in survival . Cancer . 1980;46:2731-2735.Crossref 23. O'Doherty CJ, Prescott RJ, White H, McIntyre M, Hunter JAA. Sex differences in presentation of cutaneous malignant melanoma in survival from stage 1 disease . Cancer . 1986;58:788-792.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Aug 1, 1991

References