Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011:2:538-43.
doi: 10.7150/jca.2.538. Epub 2011 Nov 1.

Malignant melanoma in the elderly: different regional disease and poorer prognosis

James B Macdonald  1 , Amylou C Dueck, Richard J Gray, Nabil Wasif, David L Swanson, Aleksandar Sekulic, Barbara A Pockaj
Affiliations

Malignant melanoma in the elderly: different regional disease and poorer prognosis

James B Macdonald et al. J Cancer. 2011.

Abstract

Purpose: Age is a poor prognostic factor in melanoma patients. Elderly melanoma patients have a different presentation and clinical course than younger patients. We evaluated the impact of age ≥70 years (yrs) on the diagnosis and natural history of melanoma.

Methods: Retrospective review of 610 patients with malignant melanoma entered into a prospective sentinel lymph node (SLN) database, treated from June 1997 to June 2010. Disease characteristics and clinical outcomes were compared between patients ≥70 yrs vs. <70 yrs of age.

Results: 237 patients (39%) were ≥70 yrs. Elderly patients had a higher proportion of head and neck melanomas (34% vs. 20%, p<0.001), and greater mean tumor thickness (2.4mm vs. 1.8mm, p<0.001). A greater proportion of T3 or T4 melanoma was seen in the elderly (p<0.001) as well as a greater mean number of mitotic figures: 3.6/mm(2) vs. 2.7/mm(2) (p=0.005). Despite greater mean thickness, the incidence of SLN metastases was less in the ≥70 yrs group with T3/T4 melanomas (18% vs. 33%, p=0.02). The elderly had a higher rate of local and in-transit recurrences, 14.5% vs. 3.4% at 5 yrs (p<0.001). 5 yr disease-specific mortality and overall mortality were worse for those ≥70 yrs: 16% vs. 8% (p=0.004), and 30% vs. 12% (p<0.001), respectively.

Conclusions: Elderly (≥70 yrs) melanoma patients present with thicker melanomas and a higher mitotic rate but have fewer SLN metastases. Melanoma in the elderly is more common on the head and neck. Higher incidence of local/in-transit metastases is seen among the elderly. Five-year disease-specific mortality and overall mortality are both worse for these patients.

Keywords: Elderly patients; melanoma; metastases.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors have declared that no conflict of interest exists.

Figures

Figure 1
Figure 1
Kaplan-Meier Plots of Time to Recurrence (A), Time to Local/In-Transit Recurrence (B), and Time to Systemic Recurrence (C).
Figure 1
Figure 1
Kaplan-Meier Plots of Time to Recurrence (A), Time to Local/In-Transit Recurrence (B), and Time to Systemic Recurrence (C).
Figure 1
Figure 1
Kaplan-Meier Plots of Time to Recurrence (A), Time to Local/In-Transit Recurrence (B), and Time to Systemic Recurrence (C).
Figure 2
Figure 2
Kaplan-Meier Plots of Overall Survival (A) and Disease-Specific Survival (B).
See this image and copyright information in PMC

References

    1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277–300. - PubMed
    1. Lasithiotakis KG, Petrakis IE, Garbe C. Cutaneous melanoma in the elderly: epidemiology, prognosis and treatment. Melanoma Res. 2010;20:163–170. - PubMed
    1. Chao C, Martin RC 2nd, Ross MI. et al. Correlation between prognostic factors and increasing age in melanoma. Ann Surg Oncol. 2004;11:259–264. - PubMed
    1. Rosenthal RA, Kavic SM. Assessment and management of the geriatric patient. Crit Care Med. 2004;32:S92–105. - PubMed
    1. Alexander HR, Turnbull AD, Salamone J, Keefe D, Melendez J. Upper abdominal cancer surgery in the very elderly. J Surg Oncol. 1991;47:82–86. - PubMed