Abstract
This study evaluates melanoma characteristics in the elderly. A retrospective descriptive analytical study was carried out by reviewing the medical records of patients aged 60 years or older, diagnosed with primary cutaneous melanoma, and treated at Hospital Erasto Gaertner, Curitiba, Paraná, from 2013 to 2017. We studied 139 patients aged 60-98 years (average, 70.3 years) and found melanoma to be more common in women (52.5%) than in men. Lesions mainly affected the limbs (32.3%) and head (24.4%), showed signs of ulceration (33.8%), and could be classified into the nodular histological (29%), extensive superficial (27%), and acral (12%) types. The average Breslow index was 1.2 mm. Metastasis occurred in 33% of the patients and mainly affected lymph nodes (36%) and the central nervous system (CNS, 20%). The first procedure conducted in 79% of the cases was surgical resection. Sentinel node mapping was carried out in 41.7% of the cases, and surgical treatment alone was indicated in 70% of the patients. The disease recurred in 34.5% of the patients, and 17.9% succumbed to the disease. These results indicate that the elderly have poorer prognosis when cancer treatment is delayed. Melanoma of the limbs and head, intermediate Breslow index, metastatic lymph node and CNS metastases, and relapse result in fatal outcomes. Direct strategies, such as prevention and early detection, as well as uniform and adequate treatment, are needed to improve disease management in the elderly.
Highlights
Life expectancy has increased worldwide over the last decade[1]
The histological types were nodular (29.5%), superficial spreading (27.3%), acral (11.5%), in situ (3%), and malignant lentigo (2.9%). This information was absent in 28 records, and 9 records revealed other forms of melanoma, such as the desmoplastic and amelanotic types (Figure 1)
The present study sought to assess the characteristics of melanoma in the elderly living in the southern region of Brazil
Summary
Life expectancy has increased worldwide over the last decade[1]. The population of persons aged over 60 years has been estimated to double by 2050, while that of persons aged over 80 years is expected to increase by four times[2]. The prevalence of melanoma in persons aged 65 years and older has increased by three times in the last 25 years; approximately 41% of the patients, at diagnosis, are elderly[3]. Melanoma is the 19th most prevalent type of cancer worldwide and has an incidence of 3.3 per 100 million[4]. In Brazil alone, 2,920 new cases among men and 3,340 among women were registered in 20174. In Europe, Australia, and the United States, the elderly represent over 50% of patients with melanoma[5].
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