Diagnosis of melanoma in the elderly and surgical implications

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

“…2,21 Other explanations for the late diagnosis in elderly individuals is deteriorating vision, loss of partner, development or increase of seborrheic keratoses, with which melanoma can be easily confused, small nevi density, which leads to lower consciousness of melanoma risk, and development of a higher proportion of melanomas in hard-to-see anatomic sites (ie, back). 22 Unfortunately, data regarding the presence of pigmented lesions other than melanoma were not available for analysis in our study. However, even if the proportion of melanomas developing on the scalp or foot was significantly higher in patients older than 65 years, we could not confirm the increase in the proportion of melanomas arising on the back of elderly persons, as reported by others.…”

Clinical and pathological melanoma differences in young and old people

“…3,8 Although numerous risk factors have been associated to the development of MM (including light eyes and low skin phototypes, presence of dysplastic naevi, tendency to freckle and family history of melanoma), the significance of some associations remains unclear, particularly in aged subgroups. [3][4][5] The risk associated with sun exposure and multiple naevi, for example, are controversial. 8,9 Traditional prognostic factors for cutaneous MM include thickness, ulceration, mitoses/mm 2 , clinical stage, anatomic location, sex and age, 10 and although some pathologic features were previously linked to lower disease specific survival rates, 4,5,7,10 some associations remain uncertain in older patients.…”

“…[3][4][5] The risk associated with sun exposure and multiple naevi, for example, are controversial. 8,9 Traditional prognostic factors for cutaneous MM include thickness, ulceration, mitoses/mm 2 , clinical stage, anatomic location, sex and age, 10 and although some pathologic features were previously linked to lower disease specific survival rates, 4,5,7,10 some associations remain uncertain in older patients. 10 In accordance to our findings, several studies suggested that melanoma is more common in older men; 3,4,6-8,10 they have focused on histologic features and/or survival, and few evaluated risk factors for melanoma.…”

“…10 In accordance to our findings, several studies suggested that melanoma is more common in older men; 3,4,6-8,10 they have focused on histologic features and/or survival, and few evaluated risk factors for melanoma. 3,5,7,8 MacDonald et al 7 found that melanoma was less likely to arise from a pre-existing naevi in patients older than 70 years. Although multiple naevi is a powerful predictive phenotypic marker for melanoma development, nevi usually involute after the 40 th decade; therefore, they are much less numerous in older patients, 9 thus explaining why we found significantly less elderly with more than 50 naevi.…”

“…2,3 Melanoma is often misdiagnosed in older people, including delayed diagnosis, inadequate staging, and suboptimal surgical/adjuvant therapies. [4][5][6] Some melanoma features seem to differ according to age, including prognosis markers and risk factors. 3,[5][6][7] This case series aimed to identify clinicopathological differences of MM between older and younger patients.…”