Localized melanoma in older patients, the impact of increasing age and comorbid medical conditions

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
M J ReesM A Henderson

Abstract

Elderly patients experience a different spectrum of disease and poorer outcomes than younger patients. This study investigated the impact of age and medical comorbidities on the management and outcome of patients ≥65 years. A retrospective review of all patients ≥65 years (481 patients with 525 primary melanomas) presenting with AJCC clinical stage I-II melanoma to an Australian cancer centre between 2000 and 2008. The median age was 74 years (65-94) with a male predominance (313 males, 65.0%) and median tumour thickness of 1.90 mm (IQR = 0.40-2.90, T1 = 33%, T2 = 20%, T3 = 24%, T4 = 23%). Inadequate surgical margins of excision (<10 mm) were common in older patients independent of site, thickness and ulceration (OR = 1.04, 95%CI = 1.00-1.07, p = 0.038). Inadequate excision margins were strongly associated with time to local recurrence, independent of age, thickness, ulceration and mitotic rate (HR = 3.00, 95%CI = 1.49-6.03, p = 0.0021), but not time to progression (p = 0.10) or disease specific survival (DSS, p = 0.27). Overall survival (OS) was strongly related to increasing age (HR = 1.04, 95%CI = 1.01-1.07, p = 0.015) and comorbid medical conditions (HR = 1.26, 95%CI = 1.12-1.42, p < 0.001), as assessed by the Charlson como...Continue Reading

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Citations

Mar 28, 2017·Nuclear Medicine Communications·Darryl SchuitevoerderJohn T Vetto
Oct 3, 2017·Aging and Disease·Simone GarcovichKetty Peris
Sep 20, 2018·International Journal of Dermatology·Oana-Diana PersaMax Schlaak
Feb 2, 2019·Pigment Cell & Melanoma Research·Kriti MishraMarianne Berwick
Aug 31, 2019·Current Medical Research and Opinion·Shweta ShahOmid Hamid
Jul 28, 2019·Acta Oncologica·Melinda S SchuurmanMarieke W J Louwman

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