BackgroundOver the past two decades, there has been a rising trend in malignant melanoma incidence worldwide. In 2008, Germany introduced a nationwide skin cancer screening program starting at age 35. The aims of this study were to analyse the distribution of malignant melanoma tumour stages over time, as well as demographic and regional differences in stage distribution and survival of melanoma patients.MethodsPooled data from 61 895 malignant melanoma patients diagnosed between 2002 and 2011 and documented in 28 German population-based and hospital-based clinical cancer registries were analysed using descriptive methods, joinpoint regression, logistic regression and relative survival.ResultsThe number of annually documented cases increased by 53.2% between 2002 (N = 4 779) and 2011 (N = 7 320). There was a statistically significant continuous positive trend in the proportion of stage UICC I cases diagnosed between 2002 and 2011, compared to a negative trend for stage UICC II. No trends were found for stages UICC III and IV respectively. Age (OR 0.97, 95% CI 0.97–0.97), sex (OR 1.18, 95% CI 1.11–1.25), date of diagnosis (OR 1.05, 95% CI 1.04–1.06), ‘diagnosis during screening’ (OR 3.24, 95% CI 2.50–4.19) and place of residence (OR 1.23, 95% CI 1.16–1.30) had a statistically significant influence on the tumour stage at diagnosis. The overall 5-year relative survival for invasive cases was 83.4% (95% CI 82.8–83.9%).ConclusionsNo distinct changes in the distribution of malignant melanoma tumour stages among those aged 35 and older were seen that could be directly attributed to the introduction of skin cancer screening in 2008.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2963-0) contains supplementary material, which is available to authorized users.

Invasive ductal carcinoma accompanied by DCIS is associated with lower LR. The prognostic value of co-existing DCIS in the adjuvant decision-making process may be considered a new independent prognostic marker. This finding needs further studies to evaluate its usefulness in premenopausal women.

Mismatch-repair deficient (MMR-D) malignancies include Lynch Syndrome (LS), which is secondary to germline mutations in one of the MMR genes, and the rare childhood-form of constitutional mismatch repair-deficiency (CMMR-D); caused by bi-allelic MMR gene mutations. A hallmark of LS-associated cancers is microsatellite instability (MSI), characterized by coding frameshift mutations (cFSM) in target genes. By contrast, tumors arising in CMMR-D patients are thought to display a somatic mutation pattern differing from LS. This study has the main goal to identify cFSM in MSI target genes relevant in CMMR-D and to compare the spectrum of common somatic mutations, including alterations in DNA polymerases POLE and D1 between LS and CMMR-D. CMMR-D-associated tumors harbored more somatic mutations compared to LS cases, especially in the TP53 gene and in POLE and POLD1, where novel mutations were additionally identified. Strikingly, MSI in classical mononucleotide markers BAT40 and CAT25 was frequent in CMMR-D cases. MSI-target gene analysis revealed mutations in CMMR-D-associated tumors, some of them known to be frequently hit in LS, such as RNaseT2, HT001, and TGFβR2. Our results imply a general role for these cFSM as potential new drivers of MMR-D tumorigenesis.

Purpose: Determination of frequency, treatment modalities used and prognoses of colorectal cancer in a population-specific analysis in relation to age. Material and Methods:In 1999 and 2000, 644/6,016 patients were documented as having colorectal carcinomas in the Cancer Registry of Rostock. 39 patients were excluded (16 cases: "in situ" carcinomas; 23 cases: insufficient data). Three age groups were formed: < 60 years, 60-74 years; ≥ 75 years. Results:The relative percentage of colorectal cancer increases with advanced age (< 60 years 7%; 60-74 years 12%, ≥ 75 years 15%; p < 0.001). In older patients with stage III carcinomas, adjuvant treatment was done less frequently in accordance with the treatment recommendations (< 60 years 83-89%; 60-74 years 67-77%; ≥ 75 years 29-36% according to stage and tumor localization); in stage IV, the use of chemotherapy was reduced (< 60 years 87.5-100%; 60-74 years 38-47%; ≥ 75 years 33-37%). In the univariate analysis, age ≥ 75 years (4-year survival rates: < 60 years 68 ± 4.1%; 60-74 years 58 ± 2.8%; ≥ 75 years 38 ± 3.7%), UICC stage and surgical treatment had a significant effect on prognosis. Adjuvant treatment had no significant effect on the whole population but on patients with UICC stage III and IV. In the multivariate analysis, however, the only independent prognostic parameters were age ≥ 75 years (p = 0.001), performance of chemotherapy (colon cancer) or radiochemotherapy (rectal cancer; p = 0.004-0.001), and tumor stage (p = 0.045-0.001). Sex (p = 0.063) and age between 60 and 74 years (p = 0.067) had a borderline influence. Conclusion:With increasing age, there is a departure in daily practice from the treatment recommendations. The patient's prognosis is dependent upon age (especially ≥ 75 years), tumor stage, and therapy. ZusammenfassungZiel: Bestimmung der Häufigkeit, der Therapiemodalitäten und der Prognose von Patienten mit kolorektalen Tumoren in einer bevölkerungsspezifischen Analyse in Bezug auf das Alter. Material und Methodik: Zwischen 1999 und 2000 wurden im Krebsregister Rostock 644/6 016 Patienten mit kolorektalen Karzinomen dokumentiert. 39 Patienten wurden ausgeschlossen (16 Fälle: In-situ-Karzinome; 23 Fälle: Insuffiziente Daten). Drei Altersgruppen wurden gebildet: < 60 Jahre, 60-74 Jahre, ≥ 75 Jahre.Ergebnisse: Der relative Anteil kolorektaler Karzinome steigt mit zunehmendem Alter (< 60 Jahre 7%; 60-74 Jahre 12%; ≥ 75 Jahre 15%; p = 0,001). Mit zunehmendem Alter wurden im Stadium III die Behandlungen weniger häufig in Übereinstimmung mit den Therapieempfehlungen durchgeführt (< 60 Jahre 83-89%; 60-74 Jahre 67-77%; ≥ 75 Jahre 29-36% gemäß Stadium und Tumorlokalisation); im Stadium IV nahm der Anteil der Patienten, die eine Chemotherapie erhielten, mit zunehmendem Alter ab (< 60 Jahre 87,5-100%; 60-74 Jahre 38-47%; ≥ 75 Jahre 33-37%). In der univariaten Analyse hatten das Alter ≥ 75 Jahre (4-Jahres-Überlebensraten: < 60 Jahre 68 ± 4,1%; 60-74 Jahre 58 ± 2,8%; ≥ 75 Jahre 38 ± 3,7%), das UICC-Stadium und die chirurgische Therapie einen signifikanten...

With increasing age, there is a departure in daily practice from the treatment recommendations. The patient's prognosis is dependent upon age (especially > or = 75 years), tumor stage, and therapy.