Optimizing the management of cutaneous melanoma in the elderly

Christina Tragos, Tina J Hieken

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The incidence of melanoma in patients aged ≥65 years is increasing. Melanoma characteristics appear to be different in the elderly, and outcomes worse. We undertook this study to characterize our experience with melanoma in the elderly and identify factors associated with outcome. Methods: We studied 244 elderly consecutive melanoma patients with clinically localized disease. Mean follow-up was 73 ± 3.7 months. Results: One-hundred thirty-two patients (54%) were male. The most common site was extremity (44%), histology superficial spreading (51%), mean thickness 1.91 mm, 16% ulcerated. T stage included 36% T1, 14% T2, 14% T3, 9% T4 tumors. Undertreatment of the primary tumor occurred in 22%, overtreatment in 6%, and inadequate lymph node staging/treatment in 22%. 23% of patients recurred, 21% died of unrelated causes, and 12% died of melanoma. Sex, tumor thickness, mitotic index, ulceration, and lymph node status were significant factors affecting disease-free survival, while tumor thickness, mitotic index, and lymph node status were significant predictors of overall survival. Conclusion: The features of melanoma in elderly patients were different from younger patients, but prognostic factors were similar. Most patients received appropriate treatment and survived >5 years. Strategies to improve early detection to facilitate optimal treatment of melanoma in the elderly are warranted.

Original languageEnglish (US)
Pages (from-to)823-835
Number of pages13
JournalSurgery
Volume150
Issue number4
DOIs
StatePublished - Oct 2011

Fingerprint

Melanoma
Skin
Mitotic Index
Lymph Nodes
Neoplasms
Disease-Free Survival
Histology
Therapeutics
Extremities
Survival
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Optimizing the management of cutaneous melanoma in the elderly. / Tragos, Christina; Hieken, Tina J.

In: Surgery, Vol. 150, No. 4, 10.2011, p. 823-835.

Research output: Contribution to journalArticle

Tragos, Christina ; Hieken, Tina J. / Optimizing the management of cutaneous melanoma in the elderly. In: Surgery. 2011 ; Vol. 150, No. 4. pp. 823-835.
@article{7d8ad3a266b84f72bf3d385dbebc0867,
title = "Optimizing the management of cutaneous melanoma in the elderly",
abstract = "Background: The incidence of melanoma in patients aged ≥65 years is increasing. Melanoma characteristics appear to be different in the elderly, and outcomes worse. We undertook this study to characterize our experience with melanoma in the elderly and identify factors associated with outcome. Methods: We studied 244 elderly consecutive melanoma patients with clinically localized disease. Mean follow-up was 73 ± 3.7 months. Results: One-hundred thirty-two patients (54{\%}) were male. The most common site was extremity (44{\%}), histology superficial spreading (51{\%}), mean thickness 1.91 mm, 16{\%} ulcerated. T stage included 36{\%} T1, 14{\%} T2, 14{\%} T3, 9{\%} T4 tumors. Undertreatment of the primary tumor occurred in 22{\%}, overtreatment in 6{\%}, and inadequate lymph node staging/treatment in 22{\%}. 23{\%} of patients recurred, 21{\%} died of unrelated causes, and 12{\%} died of melanoma. Sex, tumor thickness, mitotic index, ulceration, and lymph node status were significant factors affecting disease-free survival, while tumor thickness, mitotic index, and lymph node status were significant predictors of overall survival. Conclusion: The features of melanoma in elderly patients were different from younger patients, but prognostic factors were similar. Most patients received appropriate treatment and survived >5 years. Strategies to improve early detection to facilitate optimal treatment of melanoma in the elderly are warranted.",
author = "Christina Tragos and Hieken, {Tina J}",
year = "2011",
month = "10",
doi = "10.1016/j.surg.2011.07.054",
language = "English (US)",
volume = "150",
pages = "823--835",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Optimizing the management of cutaneous melanoma in the elderly

AU - Tragos, Christina

AU - Hieken, Tina J

PY - 2011/10

Y1 - 2011/10

N2 - Background: The incidence of melanoma in patients aged ≥65 years is increasing. Melanoma characteristics appear to be different in the elderly, and outcomes worse. We undertook this study to characterize our experience with melanoma in the elderly and identify factors associated with outcome. Methods: We studied 244 elderly consecutive melanoma patients with clinically localized disease. Mean follow-up was 73 ± 3.7 months. Results: One-hundred thirty-two patients (54%) were male. The most common site was extremity (44%), histology superficial spreading (51%), mean thickness 1.91 mm, 16% ulcerated. T stage included 36% T1, 14% T2, 14% T3, 9% T4 tumors. Undertreatment of the primary tumor occurred in 22%, overtreatment in 6%, and inadequate lymph node staging/treatment in 22%. 23% of patients recurred, 21% died of unrelated causes, and 12% died of melanoma. Sex, tumor thickness, mitotic index, ulceration, and lymph node status were significant factors affecting disease-free survival, while tumor thickness, mitotic index, and lymph node status were significant predictors of overall survival. Conclusion: The features of melanoma in elderly patients were different from younger patients, but prognostic factors were similar. Most patients received appropriate treatment and survived >5 years. Strategies to improve early detection to facilitate optimal treatment of melanoma in the elderly are warranted.

AB - Background: The incidence of melanoma in patients aged ≥65 years is increasing. Melanoma characteristics appear to be different in the elderly, and outcomes worse. We undertook this study to characterize our experience with melanoma in the elderly and identify factors associated with outcome. Methods: We studied 244 elderly consecutive melanoma patients with clinically localized disease. Mean follow-up was 73 ± 3.7 months. Results: One-hundred thirty-two patients (54%) were male. The most common site was extremity (44%), histology superficial spreading (51%), mean thickness 1.91 mm, 16% ulcerated. T stage included 36% T1, 14% T2, 14% T3, 9% T4 tumors. Undertreatment of the primary tumor occurred in 22%, overtreatment in 6%, and inadequate lymph node staging/treatment in 22%. 23% of patients recurred, 21% died of unrelated causes, and 12% died of melanoma. Sex, tumor thickness, mitotic index, ulceration, and lymph node status were significant factors affecting disease-free survival, while tumor thickness, mitotic index, and lymph node status were significant predictors of overall survival. Conclusion: The features of melanoma in elderly patients were different from younger patients, but prognostic factors were similar. Most patients received appropriate treatment and survived >5 years. Strategies to improve early detection to facilitate optimal treatment of melanoma in the elderly are warranted.

UR - http://www.scopus.com/inward/record.url?scp=80054122218&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054122218&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2011.07.054

DO - 10.1016/j.surg.2011.07.054

M3 - Article

C2 - 22000197

AN - SCOPUS:80054122218

VL - 150

SP - 823

EP - 835

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 4

ER -