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Related Experiment Videos

Thick melanoma in the elderly.

C K Chang1, Ira A Jacobs, Elena Theodosiou

  • 1Department of Surgical Oncology, University of Illinois at Chicago, Chicago, Illinois 60612, USA.

The American Surgeon
|November 25, 2003
PubMed
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Elderly patients over 65 with thick melanoma (T4) have worse survival without adjuvant therapy. Lymph node status is the key prognostic factor, guiding treatment decisions for older adults with advanced skin cancer.

Area of Science:

  • Oncology
  • Dermatology
  • Geriatric Medicine

Background:

  • Thick melanoma (≥4 mm) presents unique challenges, especially in elderly populations.
  • Limited systematic reviews focus on the natural history and survival outcomes of elderly patients (≥65 years) with thick melanoma.
  • The growing elderly population in the United States necessitates a better understanding of melanoma progression in this demographic.

Purpose of the Study:

  • To determine the natural history and survival outcomes of elderly patients (≥65 years) diagnosed with thick melanoma (T4).
  • To identify prognostic factors influencing overall survival (OS) and disease-free survival (DFS) in this specific patient group.
  • To evaluate the impact of adjuvant therapy on survival compared to historical controls.

Main Methods:

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  • Retrospective analysis of 112 patients aged 65 or older with thick melanoma (≥4 mm).
  • Data collected included patient demographics, tumor characteristics, treatment received (surgery only), and follow-up duration (mean 36 months).
  • Statistical analyses included univariate and multivariate assessments to identify predictors of OS and DFS.

    • Main Results:

    • The overall survival (OS) and disease-free survival (DFS) were 69 and 52 months, respectively.
    • Univariate analysis indicated that positive lymph nodes, high mitotic rate, and increasing tumor thickness were associated with worse OS and DFS.
    • Multivariate analysis identified lymph node status as the most significant predictor of both OS and DFS.

    Conclusions:

    • Lymph node status is the most critical prognostic factor for elderly patients with thick melanoma.
    • Elderly patients receiving no adjuvant treatment demonstrated significantly poorer outcomes compared to historical controls.
    • Treatment decisions for melanoma in patients over 65 should be age-agnostic, with adjuvant therapies considered based on prognostic factors like lymph node involvement.