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01-07-2015 | Melanomas

Older Age is Associated with a Higher Incidence of Melanoma Death but a Lower Incidence of Sentinel Lymph Node Metastasis in the SEER Databases (2003–2011)

Authors: Margaret W. Cavanaugh-Hussey, MD, MPH, Euphemia W. Mu, MD, Sewon Kang, MD, MPH, Charles M. Balch, MD, Timothy Wang, MD

Published in: Annals of Surgical Oncology | Issue 7/2015

Abstract

Purpose

Elderly melanoma patients are known to have lower survival rates than younger patients with melanoma. Paradoxically, a few recent studies have shown a lower frequency of sentinel lymph node (SLN) positivity in older individuals. This is the first analysis of a large national sample to examine the relationship between SLN metastasis and melanoma death across all age groups.

Methods

The U.S. Surveillance Epidemiology and End Results (SEER) Databases were queried to examine SLN biopsy and mortality outcomes in 158,813 melanoma cases reported from 2003 to 2011, the most current data available in SEER.

Results

In bivariate analyses of the 47,577 cases with coded tumor depths and nodal surgery, increasing age varied directly with melanoma death and inversely with SLN positivity, for tumor depths >1 mm (P < 0.001). In multivariate regression analyses, 60–79 year-olds were more likely to die of melanoma compared with 20–39 year-olds [odds ratio (OR) 1.83, 95 % confidence interval (CI) 1.64–2.05], but they were less likely to be SLN-positive (OR 0.62, 95 % CI 0.57–0.68). The inverse association between melanoma mortality and SLN positivity was most pronounced at the extremes of age.

Discussion

The finding that increasing age is associated with a higher incidence of melanoma death but a lower incidence of SLN metastasis highlights the need for further study into age-related differences in melanoma biology, immunological surveillance, and host response. It also questions whether the 5- and 10-year survival rates associated with the current melanoma staging system should be stratified by age to predict outcomes more accurately for melanoma patients.

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Title: Older Age is Associated with a Higher Incidence of Melanoma Death but a Lower Incidence of Sentinel Lymph Node Metastasis in the SEER Databases (2003–2011)
Authors: Margaret W. Cavanaugh-Hussey, MD, MPH
Euphemia W. Mu, MD
Sewon Kang, MD, MPH
Charles M. Balch, MD
Timothy Wang, MD
Publication date: 01-07-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 7/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-4538-8

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Older Age is Associated with a Higher Incidence of Melanoma Death but a Lower Incidence of Sentinel Lymph Node Metastasis in the SEER Databases (2003–2011)

Abstract

Purpose

Methods

Results

Discussion

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Abstract

Purpose

Methods

Results

Discussion

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