Melanoma characteristics in Brazil: demographics, treatment, and survival analysis

Abstract

BackgroundThe incidence of melanoma, one of the most aggressive of the skin cancers, has been increasing worldwide in the last few decades. Data from Latin America and Brazil remain scarce. We aimed to describe the demographic, clinical, and histopathological data; therapy characteristics; and survival rates of the Brazilian melanoma patient population.ResultsWe collected and analysed retrospective data from 15 years at a tertiary cancer centre. We describe patient characteristics and treatment. We calculated survival, and identified the main prognostic factors through univariate and multivariate analysis. We analysed a total of 1073 patients, with a mean age of 56.7 years. Men and women experienced similar prevalence, and 91.2% of patients had white skin. The most prevalent subtype was superficial spreading, and the most prevalent anatomic location was the trunk (32.2%), followed by the lower extremities (28%). Of all cases, 567 (52.9%) were assigned to clinical stages I and II, while 382 (32.6%) were stages III and IV. Surgery was the main treatment. Sentinel node biopsy was performed in 373 patients, with 23.8% positivity. Overall actuarial 5-year survival was 67.6%. Multivariate analysis showed that gender, serum lactate dehydrogenase (LDH) levels at diagnosis; anatomic location, TNM stage, and local recurrence were significant prognostic factors.ConclusionsOverall survival was lower than worldwide rates. The main factors influencing survival were similar to those in other populations. Local recurrence was independently associated with lower survival rates. The high prevalence of advanced cases reinforces the importance of strategies to diagnose melanomas in the early stages. There is a need for future multi-institutional prospective studies to attain a better understanding of possible socioeconomic and other influences on survival among melanoma populations in Brazil and Latin America.

Population‐based incidence and melanoma‐specific survival of cutaneous malignant melanoma in a Colombian population 2000–2009

“…22 Similarly, the proportion with Breslow thicknesses above 2 mm in the group with known Breslow thickness (48.6%) in our study is much higher than observed in population-based series of high incidence countries in the same period, such as the Netherlands (23.2% of the group with known melanomas). 23 The overall 5-year melanoma-specific survival of 79% is substantially lower than the reported relative survival observed in high incidence countries but is better than the reported survival rates of hospital-based series in the region, 24 showing the added value of population-based rather than hospital-based case series, which are usually biased toward highly specialized care providers and therefore more complex patients. The poorer survival compared to high incidence countries is probably related to the high proportion of plantar and subungual melanomas and high prevalence of ulceration in this population and melanomas with a high Breslow thickness, compared to high incidence populations.…”

Estudo retrospectivo dos pacientes portadores de melanoma cutâneo atendidos na Universidade Federal de São Paulo.

“…It is important to note that the collection of data was hampered by the deficiency of the institution's records, as it usually occurs in Brazil 36 .…”

Molecular profiling, including TERT promoter mutations, of acral lentiginous melanomas

“…In regions with vast contingent of non-white population, such as Asia, Africa, and part of America, ALM is a major concern, as it occurs in populations and skin areas that are not generally at risk for skin cancer, leading frequently to late diagnosis and low survival rates [6][7][8]. In Brazil, a country with high miscegenated and heterogeneous population with African, European and indigenous heritage, ALM is prevalent in some geographic areas [9][10][11].…”