Long‐term deaths from melanoma according to tumor thickness at diagnosis. Issue 5 (28th February 2020)

• Record Type: Journal Article
• Authors: Baade, Peter D.; Whiteman, David C.; Janda, Monika; Cust, Anne E.; Neale, Rachel E.; Smithers, Bernard Mark; Green, Adele C.; Khosrotehrani, Kiarash; Mar, Victoria; Soyer, H. Peter; Aitken, Joanne F.
• Is Part Of: International journal of cancer. Volume 147:Issue 5(2020)
• Page Start: 1391
• Page End: 1396
• Publication Date: 2020-02-28
• Subjects: Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.32930
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : There is little long‐term follow‐up information about how the number of melanoma deaths and case fatality vary over time according to the measured thickness of melanoma at diagnosis. This population‐based longitudinal cohort study examines patterns and trends in case fatality among 44, 531 people in Queensland (Australia) diagnosed with a single invasive melanoma (International Classification of Diseases for Oncology, third revision [ICD‐O‐3], C44, Morphology 872–879) between 1987 and 2011, including 11, 883 diagnosed between 1987 and 1996, with up to 20 years follow‐up (to December 2016). The 20‐year case fatality increased by thickness, with the percentage of melanoma deaths within 20 years of diagnosis being up to 4.8% for melanomas with measured thickness <0.80 mm, 10.6% for tumors 0.8 to <1.0 mm and generally more than 30% for melanomas measuring 3 mm and more. For melanomas <1.0 mm, most deaths occurred between 5 and 20 years after diagnosis, whereas for thicker melanomas the reverse was true with most deaths occurring within the first 5 years. Five‐year case fatality decreased over successive calendar time periods for melanomas <1.0 mm, but not for melanomas ≥1.0 mm. These findings demonstrate that the time course for fatal melanomas varies markedly according to tumor thickness at diagnosis. Improved understanding of the patient factors and characteristics of melanomas, in addition to tumor thickness, which increase the likelihood of progression, is needed to guide clinical diagnosis, communication with patients and ongoing surveillance pathways of patients with potentially fatal lesions. Abstract : What's new? While tumor thickness is associated with risk of death from melanoma, little is known about variations in case fatality over time based on melanoma thickness at diagnosis. In this population‐based study of patients diagnosed with a single invasive melanoma, case fatality for thin (<1.0 mm) melanoma was higher at follow‐up between 5 and 20 years than within the first 5 years after diagnosis. The opposite was found for thick melanomas. Moreover, from 1987 to 2011, 5‐year case fatality decreased for patients with thin melanomas. Greater understanding of melanoma characteristics linked to death could facilitate treatment decisions and improve patient outcomes.