Prognostic factors and epidemiological characteristics of cutaneous and mucosal head and neck melanoma.

The Clinic of Laserplastics, Riga LV, Latvia.
Stomatologija / issued by public institution "Odontologijos studija" ... [et al.] 01/2011; 13(2):49-54.
Source: PubMed

ABSTRACT OBJECTIVE. To describe the prognostic factors and epidemiological characteristics of cutaneous and mucosal head and neck melanoma and to identify the variables associated with mortality from this disease. MATERIAL AND METHODS. Patients treated for head and neck melanoma in the Oncology Centre of Latvia, Riga during a 10-year period were identified. Records from 124 cases were analyzed in a descriptive, retrospective study. For each patient, information regarding age, sex, tumor anatomic site, as well as ulceration, histological tumor subtypes, Breslow thickness and Clark invasion level was viewed. Disease specific survival rates were calculated. The frequencies of all study variables and their 95% confidence intervals were determined. Kaplan-Meier survival curves were produced to illustrate the survival differences for each variable. RESULTS. The patients' mean age was 67.36 years. The study included 81 females (65.32%) and 43 males (34.67%). The prevalent anatomical site for cutaneous head and neck melanoma was the cheek - 49% (n=55) and the intraocular site for mucosal melanoma (61.5%). A high percentage of thick cutaneous melanoma was detected. In 53 cases (47.3%) out of 112 cutaneous melanoma the tumor ulceration was found. Nodular melanoma subtype was predominating (38%). The incidence of cutaneous melanoma has increased unequally whereas mucosal melanoma of the head and neck is an uncommon cancer and the incidence rates in Latvia during a ten year period are decreasing. CONCLUSION. Female sex, advanced age, facial skin, tumor thickness, nodular subtype and ulceration carried a relevant risk of poor prognosis.


Available from: Dace Pjanova, May 28, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective/HypothesisTo evaluate age as an independent prognostic factor in cutaneous head and neck melanoma. Study DesignProspective case-control study. Methods We selected 12,195 patients from the Surveillance, Epidemiology, and End Results database with cutaneous head and neck melanoma diagnosed from 2004 to 2009. Patients were stratified into ages 1 to 44 years, 45 to 64 years, and 65+ years. Meanwhile, stage was stratified into early (American Joint Committee on Cancer [AJCC] stage I-II) versus late (AJCC stage III-IV). We calculated overall survival and compared it to age-matched cancer-free controls to obtain overall relative survival. Finally, we performed a Cox multivariate regression by age and stage. ResultsAge had a statistically significant (P<.05) stratified decrease in overall survival for both early- and late-stage melanoma. However, we only found a statistically significant (P<.05) stratified decrease in overall relative survival for late-stage melanoma. Early-stage melanoma had no statistical difference in overall relative survival between the 45 to 64 years group and all other age groups studied. Finally, our multivariate Cox regression of stage, gender, race, and age found a hazard ratio [HR] of 2.005 (95% confidence interval [CI]: 1.493-1.693, P<.001) for the 45 to 64 years age group, and an HR of 4.174 (95% CI: 3.153-5.526, P<.001) for the 65+ years age group. Conclusions Age at diagnosis is a poor prognostic factor for patients with cutaneous head and neck carcinoma. It plays an important role in survival, with a linear increase in risk as age increases. This risk is clinically significant with patients ages 65+ years, having an HR four times the risk of patients 1 to 44 years old. Level of Evidence3b. Laryngoscope, 124:462-465, 2014
    The Laryngoscope 02/2014; 124(2-2):462-465. DOI:10.1002/lary.24315 · 2.03 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To determine if sex independently affects disease-specific survival (DSS) in patients with cutaneous head and neck melanoma. Study Design: Retrospective analysis of a large population database Methods: Our study included patients in the SEER database with cutaneous head and neck melanoma diagnosed from 2004 to 2009. Any cases with a history of previous malignancy or with multiple primaries were excluded. We obtained data on stage, race, age at diagnosis, radiological treatment status, and surgical treatment status. Our analysis consisted of a Kaplan Meier analysis of disease-specific survival by age; that was supported by a multivariate cox regression of all significant variables studied. Results: 13,507 patients with cutaneous head and neck melanoma who were diagnosed between 2004 and 2009 were identified. We observed that female patients had a better prognosis than their male counterparts with 5 year disease specific survival of 90.40% (95% CI=89.03-91.72%) and 87.10% (95% CI=86.12-88.08%) respectively. Multivariable analysis demonstrated a statistically significant decrease in disease-specific hazard ratio due to female sex independent of stage, treatment, age, and race. Conclusion: Our study concludes that female sex is an independent prognostic factor for cutaneous head and neck melanoma. We demonstrated better 5-year disease-specific survival in female compared to male patients. Better prognosis could be due to multiple factors including differing hair, levels of sun exposure, and advanced male age.
    The Laryngoscope 06/2014; 124(6). DOI:10.1002/lary.24439 · 2.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: AIM: Intrauterine, early life and maternal exposures may have important consequences for cancer development in later life. The aim of this study was to examine perinatal and birth characteristics with respect to Cutaneous malignant melanoma (CMM) risk. METHODS: The Northern Ireland Child Health System database was used to examine gestational age adjusted birth weight, infant feeding practices, parental age and socioeconomic factors at birth in relation to CMM risk amongst 447,663 infants delivered between January 1971 and December 1986. Follow-up of histologically verified CMM cases was undertaken from the beginning of 1993 to 31st December 2007. Multivariable adjusted unconditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) of CMM risk. RESULTS: A total of 276 CMM cases and 440,336 controls contributed to the final analysis. In reference to normal (gestational age-adjusted) weight babies, those heaviest at birth were twice as likely to develop CMM OR 2.4 (95% CI 1.1-5.1). Inverse associations with CMM risk were observed with younger (<25years) parental age at birth and both a higher birth order and greater household density OR 0.61 (95% CI 0.37-0.99) and OR 0.56 (95% CI 0.30-1.0) respectively. CONCLUSION: This large study of early onset melanoma supports a positive association with higher birth weight (imperatively gestational age adjusted) and CMM risk which may be related to factors which drive intrauterine foetal growth. Strong inverse associations observed with higher birth order and household density suggest that early-life immune modulation may confer protection; findings which warrant further investigation in prospective analyses.
    European journal of cancer (Oxford, England: 1990) 11/2012; DOI:10.1016/j.ejca.2012.10.017 · 4.82 Impact Factor