Histopathologic variables differentially affect melanoma survival by age at diagnosis

We evaluated clinical, phenotypic, behavioral, and histopathologic variables in relationship to melanoma-specific survival by age at diagnosis among 650 population-based melanoma patients in Connecticut, with 20 years of follow-up. Only one variable, skin awareness, was significantly associated with melanoma mortality in both groups. The variables that differed between the age-groups were anatomic site, Breslow thickness, histologic subtype, mitoses, tumor-infiltrating lymphocytes (TILs), and solar elastosis. Head and neck melanoma, Breslow thickness, nodular melanoma, and solar elastosis were all significantly more likely to be associated with mortality among the older subjects; among the younger subjects, the presence of mitoses was associated with an increased probability of dying and TILs were associated with a reduced risk of mortality.