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Cutaneous malignant melanoma--clinical epidemiology and survival
M K Nair1, C Varghese, S Mahadevan
1Regional Cancer Centre, Trivandrum.
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.
Insights
Cutaneous malignant melanoma (CMM) is rare in Asia but has high mortality. This study of 79 Indian cases reveals a 5-year survival rate of 25.2%, highlighting challenges in diagnosis and treatment.
Area of Science:
- Oncology
- Epidemiology
- Dermatology
Background:
- Cutaneous malignant melanoma (CMM) incidence is low in Asian populations, with India reporting <0.5 per 1,000,000.
- Despite low incidence, CMM in Asia presents significant mortality challenges due to diagnostic and management delays.
Purpose of the Study:
- To present the clinical epidemiology and survival outcomes of 79 cutaneous malignant melanoma cases.
- To analyze the impact of referral patterns and prior surgical interventions on CMM management and prognosis in India.
Main Methods:
- Retrospective analysis of 79 CMM cases registered between 1985-1990 at a Regional Cancer Centre.
- Evaluation of clinical data, including age, sex, referral patterns, and previous treatments, to assess epidemiological trends and survival rates.
Main Results:
- The peak age incidence for CMM was observed in the 7th decade, with a male:female ratio of 1.6:1.
- All cases received initial surgical treatment at peripheral centers, complicating accurate staging and definitive surgical planning.
- The overall 5-year survival rate for CMM in this cohort was 25.2% (95% CI, 14%-38%).
Conclusions:
- Cutaneous malignant melanoma in low-incidence regions like India presents unique epidemiological characteristics and survival challenges.
- Inadequate referral patterns and initial management strategies significantly impact CMM staging and patient outcomes.
- Further epidemiological studies are needed to understand the specific etiology and optimize management of CMM in Asian populations.