Cutaneous malignant melanoma--clinical epidemiology and survival

Abstract

Melanoma of the skin is rare in the Asian population. However, this malignancy results in a high mortality due to the inadequacies in the referral pattern and management. India is one of the low incidence regions of the world. Cancer registries in India report that the age specific incidence rates for cutaneous malignant melanoma (CMM) are less than 0.5 per 1,000,000. There are only few reports in the literature on CMM in the Asian population. The Regional Cancer Centre at Trivandrum registers about 6000 new cancer cases per year and CMM forms 0.5% of them. This paper presents the clinical epidemiology and survival of 79 cases of CMM registered in the hospital cancer registry during the period 1985-90. The peak age frequency was in the 7th decade. The male:female ratio was 1.6:1. All cases had undergone a surgical manipulation in a peripheral centre, before being referred to this centre. This has posed limitation in staging and in deciding the extends of surgical excision. The overall 5-year survival rate was 25.2% (95% confidence intervals, or, CI, 14%-38%). CMM in the low incidence regions may have a different aetiology and needs to be addressed in epidemiological studies.