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Development of prognostic factors and survival in cutaneous melanoma over 25 years

An analysis of the Central Malignant Melanoma Registry of the German Dermatological Society†

  1. Petra G. Buettner Ph.D.1,
  2. Ulrike Leiter M.D.2,
  3. Thomas K. Eigentler M.D.2,
  4. Claus Garbe M.D.1,2,‡,*

Article first published online: 3 JAN 2005

DOI: 10.1002/cncr.20816

Issue

Cancer

Cancer

Volume 103, Issue 3, pages 616–624, 1 February 2005

Additional Information

How to Cite

Buettner, P. G., Leiter, U., Eigentler, T. K. and Garbe, C. (2005), Development of prognostic factors and survival in cutaneous melanoma over 25 years. Cancer, 103: 616–624. doi: 10.1002/cncr.20816

Author Information

  1. 1

    School of Public Health and Tropical Medicine, James Cook University, Townsville, Australia

  2. 2

    Section of Dermatologic Oncology, Department of Dermatology, Skin Cancer Program, Central Malignant Melanoma Registry of the German Dermatological Society, Eberhard-Karls-University of Tuebingen, Tuebingen, Germany

  1. ‡

    Fax: (011) 0049-07071-295187

*Department of Dermatology, Eberhard-Karls-University of Tuebingen, Liebermeisterstrasse 25, D-72076 Tuebingen, Germany

  1. †

    The following Departments of Dermatology were major contributors (more than 500 cases) to the Central Malignant Melanoma Registry of the German Dermatological Society: University of Berlin (Charité) (Chair: W. Sterry); Free University of Berlin (Chair: C.E. Orfanos); Berlin-Neukölln (Chair: P. Kohl); Chemnitz (Chair: J. Koch); Dortmund (Chair: P. Frosch); Dresden-Friedrichstadt (Chair: U. Wollina); University of Dresden (Chair: M. Meurer); Erfurt (Chair: R. Linse); University of Erlangen (Chair: G. Schuler); University of Essen (Chair: S. Graabe); University of Freiburg (Chair: L. Bruckner-Tudermann); Gera (Chair: J. Meyer); University of Göttingen (Chair: Ch. Neumann); University of Graz (Chair: H. Kerl); University of Greifswald (Chair: M. Jünger); University of Halle (Chair: W. Marsch); University of Hamburg (Chair: I. Moll); Hamburg-St. Georg (Chair: C. Sander); Hildesheim (Chair: H. Tronnier); University of Heidelberg (Chair: A. Enk); University of Heidelberg/Mannheim (Chair: S. Goerdt); University of Homburg (Chair: W. Tilgen); University of Jena (Chair: P. Elsner); Kassel (Chair: R. Rompel); University of Kiel (Chair: T. Schwarz); Krefeld (Chair: S. Wassilew); University of Leipzig (Chair: J. Simon); University of Lübeck (Chair: D. Zillikens); University of Magdeburg (Chair: H. Gollnick); Minden (Chair: R. Stadler); University of Munich (Chair: G. Plewig); University of Münster (Chair: Th. Luger); Nürnberg (Chair: E. Paul); University of Tuebingen (Chair: M. Röcken); University of Ulm (Chair: K. Scharfetter-Kochanek); Wiesbaden (Chair: J. Metz); University of Würzburg (Chair: E.B. Bröcker); and the University of Zürich (Chair: G. Burg).

Publication History

  1. Issue published online: 20 JAN 2005
  2. Article first published online: 3 JAN 2005
  3. Manuscript Accepted: 11 OCT 2004
  4. Manuscript Revised: 1 JUL 2004
  5. Manuscript Received: 27 APR 2004

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Keywords:

  • cutaneous melanoma;
  • time trend;
  • prognostic factors;
  • clinicopathologic characteristics;
  • survival rate

Abstract

BACKGROUND

Recent studies revealed that incidence rates of cutaneous melanoma (CM) were leveling off predominantly among younger people and patterns suggested birth-cohort effects. The current study analyzed the development of prognostic factors and survival in incident CM over 25 years.

METHODS

All 45,483 patients with incident CM diagnosed between 1976 and 2000 recorded by the German Central Malignant Melanoma Registry were considered. Linear and logistic regression analyses were used to judge time trends. Trends of survival rates were tested with the multivariate Cox model.

RESULTS

Median tumor thickness decreased from 1.81 mm in 1976 to 0.53 mm in 2000 (P < 0.0001). The percentages of in situ and level II CM increased, respectively (P < 0.0001). The percentage of ulcerated CM decreased (P < 0.0001). The percentage of superficial spreading melanoma increased, whereas the percentage of nodular melanoma decreased (P < 0.0001). These time trends were all significant in the strata of gender, however, male patients presented in general with more advanced disease. Between 1976 and 2000, the average patient got older (P < 0.0001). The percentage of patients diagnosed with the primary tumor alone increased (P < 0.0001). Across the 25 years of observation, adjusted survival rates did not increase for females (P = 0.1561) but they increased for males (P < 0.0001).

CONCLUSIONS

The data demonstrated a strong trend towards prognostically more favorable CM most likely due to earlier diagnosis. Men and older people should be the focus of health promotion activities as they presented with more advanced disease. Cancer 2005. © 2005 American Cancer Society.

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