Clinicopathologic characteristics and management trends of cutaneous invasive and in situ melanoma in older patients

A retrospective analysis of the National Cancer Data Base

Vijaya Raj Bhatt, Rajesh Shrestha, Jairam Krishnamurthy, Kailash Mosalpuria, Fausto R. Loberiza, Apar Kishor Ganti, Peter T. Silberstein

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The incidence of melanoma in older patients is on the rise. Prior studies have shown disparities in surgical management and poor survival of older patients with melanoma. Methods: This is a retrospective study of adult patients diagnosed with cutaneous invasive and in situ melanoma between 2000 and 2011 in the National Cancer Data Base. Characteristics and management of older patients (≥60 years) were compared with younger patients (20-59 years) using χ2 testing. Results: Of 476,623 total cases, 54% (n = 258,153) were diagnosed among older patients. The reported cases in the older patients increased by 1.74-fold between 2000 and 2011. The majority were white (96%), men (65%), with early-stage disease (76% stage 0-II), and superficial spreading melanoma histology (39%). Older patients, compared with younger patients, were more likely to be men (65% versus 49%, p <0.0001), and have in situ melanoma (28% versus 21%, p <0.0001); less likely to have nodal metastases (7% versus 9%, p <0.0001), receive care in academic centers (30% versus 35%, p <0.0001), undergo wide excision or major amputation for stage I-III disease (68% versus 72%, p <0.0001) and systemic therapy for stage III (18% versus 45%, p <0.0001) and IV disease (30% versus 50%, p <0.0001). Conclusion: Older patients with melanoma are less likely to receive care in academic centers, undergo wide excision for stage I-III disease and receive systemic therapy for stage III-IV disease. Particularly, the utilization of systemic therapy is markedly low. This disparity is particularly important with the availability of less intense more effective therapies.

Original languageEnglish
Pages (from-to)4-11
Number of pages8
JournalTherapeutic Advances in Medical Oncology
Volume7
Issue number1
DOIs
StatePublished - Jan 19 2015

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Melanoma
Databases
Skin
Neoplasms
Therapeutics
Amputation
Histology
Retrospective Studies
Neoplasm Metastasis
Survival
Incidence

All Science Journal Classification (ASJC) codes

  • Oncology

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Clinicopathologic characteristics and management trends of cutaneous invasive and in situ melanoma in older patients : A retrospective analysis of the National Cancer Data Base. / Bhatt, Vijaya Raj; Shrestha, Rajesh; Krishnamurthy, Jairam; Mosalpuria, Kailash; Loberiza, Fausto R.; Ganti, Apar Kishor; Silberstein, Peter T.

In: Therapeutic Advances in Medical Oncology, Vol. 7, No. 1, 19.01.2015, p. 4-11.

Research output: Contribution to journalArticle

Bhatt, Vijaya Raj ; Shrestha, Rajesh ; Krishnamurthy, Jairam ; Mosalpuria, Kailash ; Loberiza, Fausto R. ; Ganti, Apar Kishor ; Silberstein, Peter T. / Clinicopathologic characteristics and management trends of cutaneous invasive and in situ melanoma in older patients : A retrospective analysis of the National Cancer Data Base. In: Therapeutic Advances in Medical Oncology. 2015 ; Vol. 7, No. 1. pp. 4-11.
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abstract = "Background: The incidence of melanoma in older patients is on the rise. Prior studies have shown disparities in surgical management and poor survival of older patients with melanoma. Methods: This is a retrospective study of adult patients diagnosed with cutaneous invasive and in situ melanoma between 2000 and 2011 in the National Cancer Data Base. Characteristics and management of older patients (≥60 years) were compared with younger patients (20-59 years) using χ2 testing. Results: Of 476,623 total cases, 54{\%} (n = 258,153) were diagnosed among older patients. The reported cases in the older patients increased by 1.74-fold between 2000 and 2011. The majority were white (96{\%}), men (65{\%}), with early-stage disease (76{\%} stage 0-II), and superficial spreading melanoma histology (39{\%}). Older patients, compared with younger patients, were more likely to be men (65{\%} versus 49{\%}, p <0.0001), and have in situ melanoma (28{\%} versus 21{\%}, p <0.0001); less likely to have nodal metastases (7{\%} versus 9{\%}, p <0.0001), receive care in academic centers (30{\%} versus 35{\%}, p <0.0001), undergo wide excision or major amputation for stage I-III disease (68{\%} versus 72{\%}, p <0.0001) and systemic therapy for stage III (18{\%} versus 45{\%}, p <0.0001) and IV disease (30{\%} versus 50{\%}, p <0.0001). Conclusion: Older patients with melanoma are less likely to receive care in academic centers, undergo wide excision for stage I-III disease and receive systemic therapy for stage III-IV disease. Particularly, the utilization of systemic therapy is markedly low. This disparity is particularly important with the availability of less intense more effective therapies.",
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T1 - Clinicopathologic characteristics and management trends of cutaneous invasive and in situ melanoma in older patients

T2 - A retrospective analysis of the National Cancer Data Base

AU - Bhatt, Vijaya Raj

AU - Shrestha, Rajesh

AU - Krishnamurthy, Jairam

AU - Mosalpuria, Kailash

AU - Loberiza, Fausto R.

AU - Ganti, Apar Kishor

AU - Silberstein, Peter T.

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N2 - Background: The incidence of melanoma in older patients is on the rise. Prior studies have shown disparities in surgical management and poor survival of older patients with melanoma. Methods: This is a retrospective study of adult patients diagnosed with cutaneous invasive and in situ melanoma between 2000 and 2011 in the National Cancer Data Base. Characteristics and management of older patients (≥60 years) were compared with younger patients (20-59 years) using χ2 testing. Results: Of 476,623 total cases, 54% (n = 258,153) were diagnosed among older patients. The reported cases in the older patients increased by 1.74-fold between 2000 and 2011. The majority were white (96%), men (65%), with early-stage disease (76% stage 0-II), and superficial spreading melanoma histology (39%). Older patients, compared with younger patients, were more likely to be men (65% versus 49%, p <0.0001), and have in situ melanoma (28% versus 21%, p <0.0001); less likely to have nodal metastases (7% versus 9%, p <0.0001), receive care in academic centers (30% versus 35%, p <0.0001), undergo wide excision or major amputation for stage I-III disease (68% versus 72%, p <0.0001) and systemic therapy for stage III (18% versus 45%, p <0.0001) and IV disease (30% versus 50%, p <0.0001). Conclusion: Older patients with melanoma are less likely to receive care in academic centers, undergo wide excision for stage I-III disease and receive systemic therapy for stage III-IV disease. Particularly, the utilization of systemic therapy is markedly low. This disparity is particularly important with the availability of less intense more effective therapies.

AB - Background: The incidence of melanoma in older patients is on the rise. Prior studies have shown disparities in surgical management and poor survival of older patients with melanoma. Methods: This is a retrospective study of adult patients diagnosed with cutaneous invasive and in situ melanoma between 2000 and 2011 in the National Cancer Data Base. Characteristics and management of older patients (≥60 years) were compared with younger patients (20-59 years) using χ2 testing. Results: Of 476,623 total cases, 54% (n = 258,153) were diagnosed among older patients. The reported cases in the older patients increased by 1.74-fold between 2000 and 2011. The majority were white (96%), men (65%), with early-stage disease (76% stage 0-II), and superficial spreading melanoma histology (39%). Older patients, compared with younger patients, were more likely to be men (65% versus 49%, p <0.0001), and have in situ melanoma (28% versus 21%, p <0.0001); less likely to have nodal metastases (7% versus 9%, p <0.0001), receive care in academic centers (30% versus 35%, p <0.0001), undergo wide excision or major amputation for stage I-III disease (68% versus 72%, p <0.0001) and systemic therapy for stage III (18% versus 45%, p <0.0001) and IV disease (30% versus 50%, p <0.0001). Conclusion: Older patients with melanoma are less likely to receive care in academic centers, undergo wide excision for stage I-III disease and receive systemic therapy for stage III-IV disease. Particularly, the utilization of systemic therapy is markedly low. This disparity is particularly important with the availability of less intense more effective therapies.

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