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 language | English |
|---|---|
| Pages (from-to) | 4-11 |
| Number of pages | 8 |
| Journal | Therapeutic Advances in Medical Oncology |
| Volume | 7 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 19 2015 |
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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 journal › Article
}
TY - JOUR
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.
PY - 2015/1/19
Y1 - 2015/1/19
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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U2 - 10.1177/1758834014559936
DO - 10.1177/1758834014559936
M3 - Article
VL - 7
SP - 4
EP - 11
JO - Therapeutic Advances in Medical Oncology
JF - Therapeutic Advances in Medical Oncology
SN - 1758-8340
IS - 1
ER -