Gender differences in cutaneous melanoma: Demographics, prognostic factors, and survival outcomes

Abstract

Several recent studies have reported a considerably higher overall survival (OS) rate in females in various geographic regions This study further investigates the characteristics of melanoma that contribute to OS of women residing in the United States. Chi-square, Kaplan-Meier, and Cox regression models were used to analyze differences in demographics, treatment, and survival of invasive cutaneous melanoma in men and women diagnosed from 2004 to 2016 in the National cancer database. In 316 966 patients met inclusion criteria. Men had a significantly higher median age of diagnosis at 61 years (interquartile range or IQR: 51-72) in comparison to women where the median age of diagnosis was 55 years (IQR: 43-68) (P < .0001). The most common primary site for men was the trunk (35.5%), whereas the lower extremities were the most common primary site for women (30.3%). Women had a higher 5 year (82.6%) and 10 year (73.1%) OS compared to 5 year and 10 year OS of 72.2% and 58.7%, respectively, in men (P < .0001). When adjusting for confounders, female gender was independently associated with improved OS (ref: male HR = 0.791; 95% confidence interval 0.773-0.809; P < .0001). Overall, we conclude that female gender is an independent favorable prognostic factor for melanoma survival.

Investigating Serum and Tissue Expression Identified a Cytokine/Chemokine Signature as a Highly Effective Melanoma Marker

“…Furthermore, significant gender-specific differences were identified in Eotaxin and MCP-1 expression (Table 6), as well as in GM-CSF, TNF-α, IL-9, MIP-1a, IL-8, PDGF-BB, and MCP-1 (Tables S3-S5). This finding indicated the molecular bases possibly underlying the different incidence and different mortality rates in male vs. female melanoma [28][29][30][31][32], as well as the unexpected better response of immunotherapies in men than in women [33].…”

Prognostic Value of Lymph Node Ratio in Cutaneous Melanoma: A Systematic Review

“…Inferior clinical outcomes have been observed in men compared to women with melanoma. In a study comparing melanoma outcomes in men and women, Behbahani et al reported that men were diagnosed at 61 years of age, while women were diagnosed earlier at a median age of 55 years [28]. In the same study, women had a mean OS of 11.1 years and a 10-year survival rate of 73.1%, while men had a mean OS of 9.6 years and a 10-year survival rate of 58.7%.…”

Significant Improvement in Melanoma Survival Over the Last Decade: A Hungarian Nationwide Study Between 2011–2019

“…Our findings are consistent with those reported by the Cancer Research UK database which reported 5-year net survival rates of 92.4% in women and 87.6% in men in the 2010-2011 period (39). The survival advantage of women in melanoma is well-established (10,40,41). A recent large analysis from the U.S. Surveillance, Epidemiology, and End Results (SEER) cancer database showed significantly better 3-and 5-year cancer-specific melanoma survival rates among women compared to men (40), and Behbanani et al also reported better 5-year overall survival for female melanoma patients based on the U.S. National Cancer Registry (10).…”

“…The survival advantage of women in melanoma is well-established (10,40,41). A recent large analysis from the U.S. Surveillance, Epidemiology, and End Results (SEER) cancer database showed significantly better 3-and 5-year cancer-specific melanoma survival rates among women compared to men (40), and Behbanani et al also reported better 5-year overall survival for female melanoma patients based on the U.S. National Cancer Registry (10). The positive prognostic significance of female sex may be explained by various factors.…”

“…Multiple prognostic factors have been associated with survival in melanoma including age, sex, anatomic site, ulceration, or stage (8,9). Female sex is a positive prognostic factor in melanoma, which is demonstrated by a number of studies showing better survival among women compared to men (10,11). Furthermore, other pathological characteristics such as melanoma thickness (Breslow thickness) are also strongly related to the survival, with thinner lesions having better survival rates than thicker lesions (5).…”