Desmoplastic Melanoma: Clinical Characteristics and Survival in the US Population

Abstract

Desmoplastic melanoma (DM) is a rare variant of invasive malignancy of the skin pigmented cells. We present a comprehensive study reporting on US demographics, disease characteristics, and survival, to contribute to the current knowledge and raise awareness of this rare disease. Materials and methods The demographics of DM patients diagnosed from January 1, 2004, to December 31, 2015, were obtained by querying the National Cancer Database. The characteristics of DM were compared with common malignant melanoma (CMM) using univariate and multivariate regression models. Five-year overall survival (OS) curves were estimated using Kaplan-Meier analyses and the Cox proportional regression model. Results Our query found 5,895 patients diagnosed with DM and 292,939 patients with CMM. DM tended to present at an older age, a more advanced stage, and with a Breslow depth greater than 4 mm at diagnosis (P<.05). The Kaplan-Meier survival analysis demonstrated a five-year OS for DM and CMM of 75% and 76%, respectively, without any statistical difference (P=.07). Cox regression analysis demonstrated that age at diagnosis and comorbidities were independent predictors of five-year OS for DM (P<.001). Conclusions Older age, advanced stage, and higher Breslow depth were found to be independent positive factors associated with DM.

An unusual case of cutaneous desmoplastic melanoma

“…This raises the suggestion that DM has a more benign biological course and a better survival rate compared to CMM. However, the statistical analysis shows similar 5-year survival rate (75%), which is probably a result of the delay of the DMM diagnosis (2). Remarkably, the mean Breslow thickness at the time of the diagnosis is more than 4mm (1), which is 4 times greater than the mean diagnostic CMM Breslow thickiness (3).…”

“…rate compared to CMM (9) as well as higher frequency of regression (2). Usually, regression is associated with a better outcome, corresponding to the ability of the immune system to fight the tumor (10).…”

“…It is a diagnostically challenging disease due to the non-specific clinical appearance, encompassing a spectrum of atypical variants. The low incidence rate further complicates the accumulation of sufficient scientific data (2).…”

Acral lentiginous melanoma: A retrospective study

“…Substantially, the studies of Richards et al 28,29 found that despite the existence of media operation to promote prevention, 25% of the patients believed that removing a tumor was dangerous, only 24.8% were conscious about the gravity of melanoma, and others just assumed that a lesion could not be malignant if asymptomatic. The signs and symptoms that encouraged a fast consultation of a healthcare professional were the late ones, such as bleeding, whereas observing the standard ABCDE signs led to delay in seeking medical attention 30,31,48‐53 …”

Evolving Treatments and Future Therapeutic Targets in Desmoplastic Melanoma

“…The overall survival for patients with DM is relatively favorable despite its depth at diagnosis with median survival at 5 and 10 years of 84.8 and 79.2 %, respectively [6]. Advanced age of the patient, higher stage of the tumor as well as increased Breslow depth were found to be independent positive factors associated with DM [7]. While established DM treatment options are surgical excision, sentinel lymph node biopsy, systemic chemotherapy and radiation therapy, a number of genetic mutations associated with DM have shown it to be responsive to targeted therapies.…”