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Malignant Melanoma in the Elderly: Different Regional Disease and Poorer Prognosis

By James B. Macdonald, Amylou C. Dueck, Richard J. Gray, Nabil Wasif, David L. Swanson and Barbara A. Pockaj


licenses/by-nc-nd/3.0/). Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited. Received: 2011.08.24; Accepted: 2011.10.20; Published: 2011.11.01 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 yr

Year: 2013
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