Gender-related differences in outcome for melanoma patients

Charles R. Scoggins, Merrick I. Ross, Douglas S. Reintgen, R. Dirk Noyes, James S. Goydos, Peter D. Beitsch, Marshall M. Urist, Stephan Ariyan, Jeffrey J. Sussman, Michael J. Edwards, Anees B. Chagpar, Robert C.G. Martin, Arnold J. Stromberg, Lee Hagendoorn, Kelly M. McMasters

Research output: Contribution to journalArticlepeer-review

144 Scopus citations

Abstract

OBJECTIVE: To better understand the factors associated with the well-established gender difference in survival for patients with melanoma. SUMMARY BACKGROUND DATA: Gender is an important factor in patients with cutaneous melanoma. Male patients have a worse outcome when compared with females. The reasons for this difference are poorly understood. METHODS: This prospective multi-institutional study included patients aged 18 to 70 years with melanomas ≥1.0 mm Breslow thickness. Wide excision and sentinel lymph node (SLN) biopsy was performed in all patients. Clinicopathologic factors, including gender, were assessed and correlated with disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS). RESULTS: A total of 3324 patients were included in the covariate analyses; 1829 patients had follow-up data available and were included in the survival analyses. Median follow-up was 30 months. On univariate analysis, men (n = 1906) were more likely than women to be older than 60 years (P < 0.0001), have thicker melanomas (P < 0.0001), have primary tumor regression (P = 0.0054), ulceration (P < 0.0001), and axial primary tumor location (P < 0.0001). On multivariate analysis, age (P = 0.0002), thickness (P < 0.0001), ulceration (P = 0.015), and location (P < 0.0001) remained significant in the model. There was no difference in the rate of SLN metastasis between men and women (P = 0.37) on multivariate analysis. When factors affecting survival were considered, the prognosis was worse for men as validated by lower DFS (P = 0.0005), DDFS (P < 0.0001), and OS (P < 0.0001). CONCLUSIONS: Male gender is associated with a greater incidence of unfavorable primary tumor characteristics without an increased risk for nodal metastasis. Nonetheless, gender is an independent factor affecting survival.

Original languageEnglish
Pages (from-to)693-698
Number of pages6
JournalAnnals of Surgery
Volume243
Issue number5
DOIs
StatePublished - May 2006

ASJC Scopus subject areas

  • Surgery

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