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Comparative Study
. 2006 May;243(5):693-8; discussion 698-700.
doi: 10.1097/01.sla.0000216771.81362.6b.

Gender-related differences in outcome for melanoma patients

Charles R Scoggins  1 , Merrick I Ross, Douglas S Reintgen, R Dirk Noyes, James S Goydos, Peter D Beitsch, Marshall M Urist, Stephan Ariyan, Jeffrey J Sussman, Michael J Edwards, Anees B Chagpar, Robert C G Martin, Arnold J Stromberg, Lee Hagendoorn, Kelly M McMasters; Sunbelt Melanoma Trial
Affiliations
Comparative Study

Gender-related differences in outcome for melanoma patients

Charles R Scoggins et al. Ann Surg. 2006 May.

Abstract

Objective: To better understand the factors associated with the well-established gender difference in survival for patients with melanoma.

Summary background data: Gender is an important factor in patients with cutaneous melanoma. Male patients have a worse outcome when compared with females. The reasons for this difference are poorly understood.

Methods: This prospective multi-institutional study included patients aged 18 to 70 years with melanomas > or =1.0 mm Breslow thickness. Wide excision and sentinel lymph node (SLN) biopsy was performed in all patients. Clinicopathologic factors, including gender, were assessed and correlated with disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS).

Results: A total of 3324 patients were included in the covariate analyses; 1829 patients had follow-up data available and were included in the survival analyses. Median follow-up was 30 months. On univariate analysis, men (n = 1906) were more likely than women to be older than 60 years (P < 0.0001), have thicker melanomas (P < 0.0001), have primary tumor regression (P = 0.0054), ulceration (P < 0.0001), and axial primary tumor location (P < 0.0001). On multivariate analysis, age (P = 0.0002), thickness (P < 0.0001), ulceration (P = 0.015), and location (P < 0.0001) remained significant in the model. There was no difference in the rate of SLN metastasis between men and women (P = 0.37) on multivariate analysis. When factors affecting survival were considered, the prognosis was worse for men as validated by lower DFS (P = 0.0005), DDFS (P < 0.0001), and OS (P < 0.0001).

Conclusions: Male gender is associated with a greater incidence of unfavorable primary tumor characteristics without an increased risk for nodal metastasis. Nonetheless, gender is an independent factor affecting survival.

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Figures

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FIGURE 1. Survival comparisons between male and female melanoma patients. DFS, disease-free survival; DDFS, distant disease-free survival; OS, overall survival.
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FIGURE 2. Survival comparison between male and female melanoma patients with a negative sentinel lymph node. DFS, disease-free survival; DDFS, distant disease-free survival; OS, overall survival; SLN, sentinel lymph node.
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FIGURE 3. Survival comparison between male and female melanoma patients with a positive sentinel lymph node. DFS, disease-free survival; DDFS, distant disease-free survival; OS, overall survival; SLN, sentinel lymph node.
See this image and copyright information in PMC

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