Correlation between prognostic factors and increasing age in melanoma

Celia Chao, Robert C G Martin, Merrick I. Ross, Douglas S. Reintgen, Michael J. Edwards, R. Dirk Noyes, Lee J. Hagendoorn, Arnold J. Stromberg, Kelly M. McMasters

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

Background: Age of patients with melanoma varies directly with mortality and inversely with the presence of sentinel lymph node (SLN) metastasis. To gain further insight into this apparent paradox, we analyzed the relationship between age and other major prognostic factors. Methods: The Sunbelt Melanoma Trial is a prospective, randomized study with 79 institutions involving SLN biopsy for melanoma. Eligible patients were 18 to 70 years old with melanoma of ≥1.0-mm Breslow thickness and clinically N0 regional lymph nodes. SLNs were evaluated by serial histological sections and immunohistochemistry for S-100 protein. Results: A total of 3076 patients were enrolled in the study, with a median follow-up of 19 months. Five age groups were examined: 18 to 30, 31 to 40, 41 to 50, 51 to 60, and 61 to 70 years. Trends between age and several key prognostic factors was identified: as age group increased, so did Breslow thickness (analysis of variance; P < .001), the incidence of ulceration and regression, and the proportion of male patients (each variable: χ2, P < .001). The incidence of SLN metastasis, however, declined with increasing age (χ2; P < .001). Conclusions: As age increases, so does Breslow thickness, the incidence of ulceration and regression, and the proportion of male patients-all poor prognostic factors. However, the frequency of SLN metastasis declines with increasing age. It is not known whether this represents a decreased sensitivity (higher false-negative rate) of the SLN procedure in older patients or a different biological behavior (hematogenous spread) of melanomas in older patients.

Original languageEnglish (US)
Pages (from-to)259-264
Number of pages6
JournalAnnals of Surgical Oncology
Volume11
Issue number3
DOIs
StatePublished - 2004

Fingerprint

Melanoma
Neoplasm Metastasis
Incidence
Age Groups
Sentinel Lymph Node Biopsy
S100 Proteins
Analysis of Variance
Lymph Nodes
Immunohistochemistry
Prospective Studies
Mortality
Sentinel Lymph Node

Keywords

  • Age
  • Melanoma
  • Prognostic factors
  • Sentinel lymph node

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Chao, C., Martin, R. C. G., Ross, M. I., Reintgen, D. S., Edwards, M. J., Noyes, R. D., ... McMasters, K. M. (2004). Correlation between prognostic factors and increasing age in melanoma. Annals of Surgical Oncology, 11(3), 259-264. https://doi.org/10.1245/ASO.2004.04.015

Correlation between prognostic factors and increasing age in melanoma. / Chao, Celia; Martin, Robert C G; Ross, Merrick I.; Reintgen, Douglas S.; Edwards, Michael J.; Noyes, R. Dirk; Hagendoorn, Lee J.; Stromberg, Arnold J.; McMasters, Kelly M.

In: Annals of Surgical Oncology, Vol. 11, No. 3, 2004, p. 259-264.

Research output: Contribution to journalArticle

Chao, C, Martin, RCG, Ross, MI, Reintgen, DS, Edwards, MJ, Noyes, RD, Hagendoorn, LJ, Stromberg, AJ & McMasters, KM 2004, 'Correlation between prognostic factors and increasing age in melanoma', Annals of Surgical Oncology, vol. 11, no. 3, pp. 259-264. https://doi.org/10.1245/ASO.2004.04.015
Chao, Celia ; Martin, Robert C G ; Ross, Merrick I. ; Reintgen, Douglas S. ; Edwards, Michael J. ; Noyes, R. Dirk ; Hagendoorn, Lee J. ; Stromberg, Arnold J. ; McMasters, Kelly M. / Correlation between prognostic factors and increasing age in melanoma. In: Annals of Surgical Oncology. 2004 ; Vol. 11, No. 3. pp. 259-264.
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AU - Ross, Merrick I.

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AU - Noyes, R. Dirk

AU - Hagendoorn, Lee J.

AU - Stromberg, Arnold J.

AU - McMasters, Kelly M.

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N2 - Background: Age of patients with melanoma varies directly with mortality and inversely with the presence of sentinel lymph node (SLN) metastasis. To gain further insight into this apparent paradox, we analyzed the relationship between age and other major prognostic factors. Methods: The Sunbelt Melanoma Trial is a prospective, randomized study with 79 institutions involving SLN biopsy for melanoma. Eligible patients were 18 to 70 years old with melanoma of ≥1.0-mm Breslow thickness and clinically N0 regional lymph nodes. SLNs were evaluated by serial histological sections and immunohistochemistry for S-100 protein. Results: A total of 3076 patients were enrolled in the study, with a median follow-up of 19 months. Five age groups were examined: 18 to 30, 31 to 40, 41 to 50, 51 to 60, and 61 to 70 years. Trends between age and several key prognostic factors was identified: as age group increased, so did Breslow thickness (analysis of variance; P < .001), the incidence of ulceration and regression, and the proportion of male patients (each variable: χ2, P < .001). The incidence of SLN metastasis, however, declined with increasing age (χ2; P < .001). Conclusions: As age increases, so does Breslow thickness, the incidence of ulceration and regression, and the proportion of male patients-all poor prognostic factors. However, the frequency of SLN metastasis declines with increasing age. It is not known whether this represents a decreased sensitivity (higher false-negative rate) of the SLN procedure in older patients or a different biological behavior (hematogenous spread) of melanomas in older patients.

AB - Background: Age of patients with melanoma varies directly with mortality and inversely with the presence of sentinel lymph node (SLN) metastasis. To gain further insight into this apparent paradox, we analyzed the relationship between age and other major prognostic factors. Methods: The Sunbelt Melanoma Trial is a prospective, randomized study with 79 institutions involving SLN biopsy for melanoma. Eligible patients were 18 to 70 years old with melanoma of ≥1.0-mm Breslow thickness and clinically N0 regional lymph nodes. SLNs were evaluated by serial histological sections and immunohistochemistry for S-100 protein. Results: A total of 3076 patients were enrolled in the study, with a median follow-up of 19 months. Five age groups were examined: 18 to 30, 31 to 40, 41 to 50, 51 to 60, and 61 to 70 years. Trends between age and several key prognostic factors was identified: as age group increased, so did Breslow thickness (analysis of variance; P < .001), the incidence of ulceration and regression, and the proportion of male patients (each variable: χ2, P < .001). The incidence of SLN metastasis, however, declined with increasing age (χ2; P < .001). Conclusions: As age increases, so does Breslow thickness, the incidence of ulceration and regression, and the proportion of male patients-all poor prognostic factors. However, the frequency of SLN metastasis declines with increasing age. It is not known whether this represents a decreased sensitivity (higher false-negative rate) of the SLN procedure in older patients or a different biological behavior (hematogenous spread) of melanomas in older patients.

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