Association between the anatomic distribution of melanoma and sex

Clark, Lily; Shin, Daniel B.; Troxel, Andrea B.; Khan, Shahbaz; Sober, Arthur J.; Ming, Michael E.

doi:10.1016/j.jaad.2006.12.028

Cited by 56 publications

(49 citation statements)

References 5 publications

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“…Declines and stabilizations in incidence rates for specific body sites have been noted by several others 3,15,17,18 and this is congruent with our study. The observed changes for female patients younger than 60 years may suggest that sun-protective behaviors may have been adopted or that lifestyle changes directly or indirectly related to sun exposure (eg, the increasing number of women in the workforce) are having a positive effect.…”

Section: Discussionsupporting

confidence: 94%

“…2,3,15,16 In addition, changes have also been observed in the anatomic distribution of CMMs. 15,17,18 Such transformations may suggest that there have been marked changes in the influence of risk factors for the disease. These changes may be the result of increased awareness, increased sun-protective practices, and differences in sun-exposure behaviors (either recreational or occupational).…”

mentioning

confidence: 99%

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Incidence and anatomic presentation of cutaneous malignant melanoma in central Canada during a 50-year period: 1956 to 2005

Pruthi

Guilfoyle

Nugent

et al. 2009

Journal of the American Academy of Dermatology

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Section: Discussionsupporting

confidence: 94%

mentioning

confidence: 99%

Incidence and anatomic presentation of cutaneous malignant melanoma in central Canada during a 50-year period: 1956 to 2005

Pruthi

Guilfoyle

Nugent

et al. 2009

Journal of the American Academy of Dermatology

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“…Melanomas on the lower extremities, which are more common in female, have a better prognosis than tumors located on the trunk, which are more commonly seen in male patients [15]. The anatomical site of CM may be related to sun exposure and clothing habits, although it has been hypothesized that sex-related genetic factors may influence the likelihood that a melanoma would occur on a given body site [16,17]. CMs located on the trunk metastasize more frequently to distant sites than tumors located on a lower limb.…”

Section: Discussionmentioning

confidence: 99%

Sex differences in survival of cutaneous melanoma are age dependent

et al. 2011

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This study identified sex differences in clinical presentation and survival for primary cutaneous melanoma without clinical evidence of metastasis at diagnosis from 1976 to 2008 in southern Germany. Melanoma-specific survival curves and estimated survival probabilities were generated using the Kaplan-Meier method. Multivariate survival analyses were carried out using the Cox modeling. Male patients had significantly thicker and more frequently ulcerated tumors and a lower 10-year disease-specific survival (DSS) and recurrence-free survival probability compared with females among patients of 43 years old or younger (DSS: 86.1 vs. 93.2%, P<0.001) and 44-60 years old (DSS: 83.5 vs. 90.1%, P<0.001). The survival advantage of female patients in terms of 10-year DSS and 10-year recurrence-free survival was not observed after an age of 60 years (P=0.21 and 0.51, respectively). Sex was of prognostic importance for DSS and survival after recurrence [hazards ratio (HR): 1.3; 95% confidence interval (CI): 1.1-1.6; P=0.002 and HR: 1.2; 95% CI: 1.0-1.5; P=0.018, respectively]. Stratified by age groups, sex remained of prognostic importance for DSS only in patients of 43 years or younger, and 44-60 years old (HR: 1.5; 95% CI: 1.0-2.1; P=0.03 and HR: 1.4; 95% CI: 1.1-2.0; P=0.02, respectively). Sex is an independent prognostic factor in surviving melanoma. The sex difference in survival with a better outcome for women is confined to melanoma patients of 60 years and younger. In addition, in younger age groups, male patients present with prognostically unfavorable features of primary melanoma. A female survival advantage is also known for other solid tumors such as colon and lung cancer; however, age dependency has not been studied.

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“…However, this concern is mitigated by our recent determination that the population from our PLC has a mean tumor thickness distribution and a Clark level distribution comparable to those in the US population-based Surveillance, Epidemiology, and End Results cancer registry. 16 In addition, any study that examines a patient population over several decades raises the question of whether that patient population …”

Section: Discussionmentioning

confidence: 99%

Characteristics associated with early and late melanoma metastases

Brauer

Wriston

Troxel

et al. 2009

Cancer

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BACKGROUND: Differences in risk factors for metastases at different time intervals after treatment have been described in several malignancies; however, to the authors' knowledge, no extensive study examining this issue in melanoma has been conducted to date. METHODS: The authors performed a nested case-control study of patients with melanoma who presented with only local disease. Patients in the case group included 549 patients who developed metastases 6 months after surgery. Of these, 320 patients developed metastasis within 3 years after undergoing definitive surgery (early metastases [EM]), and 70 patients developed metastasis 8 years after undergoing definitive surgery (late metastases [LM]). For each case, a control patient was chosen who had melanoma but who did not develop metastases in the same interval. Univariate and conditional multivariate logistic regression were used in the analysis of 34 clinical and tumor characteristics. RESULTS: Multivariate analysis confirmed previously established risk factors for metastases, such as increasing tumor thickness. In addition, the authors discovered that a personal history of nonmelanoma skin cancer (P ¼ .006) and a history of cancer other than skin cancer (P ¼ .020) also were associated with metastasis. In comparing the 320 EM patients with the 70 LM patients, EM patients were more likely to have thicker lesions (P < .001), ulcerated lesions (P ¼ .016), and a history of nonmelanoma skin cancer (P ¼ .024). CONCLUSIONS: In this study, 2 potentially novel risk factors for melanoma metastases were identified, and different profiles of risk factors were constructed for EM versus LM. These differences may be important in future risk identification and stratification for clinical trials and for the management and treatment of patients with melanoma.

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Association between the anatomic distribution of melanoma and sex

Cited by 56 publications

References 5 publications

Incidence and anatomic presentation of cutaneous malignant melanoma in central Canada during a 50-year period: 1956 to 2005

Incidence and anatomic presentation of cutaneous malignant melanoma in central Canada during a 50-year period: 1956 to 2005

Sex differences in survival of cutaneous melanoma are age dependent

Characteristics associated with early and late melanoma metastases

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