Gender differences in pediatric and adolescent melanoma: A retrospective analysis of 4645 cases

Abstract

There is paucity of data on how genderimpacts melanoma prognosis in pediatric and adolescent patients. This study explores gender differences in presentation and survival among pediatric and adolescent patients with melanoma. The National Cancer Database 2004-2018 was queried for cases of primary invasive cutaneous melanoma in pediatric and adolescent patients (birth to 21years) for a retrospective cohort study. Of the 4645 cases, 63.4% were female. Median Breslow depth was 1.05mm for males (interquartile range 0.50-2.31) and 0.80mm for females (interquartile range 0.40-1.67; P<.001). Trunk was the most common primary site for females (34.3%) and males (32.9%). More females than males were diagnosed with stage I disease (67.8% vs 53.6%). Males had higher rates of regional lymph node positivity (27.9% vs 18.1%; P<.001) and ulceration (17.1% vs 11.4%; P<.001). Five-year overall survival was 95.9% for females and 92.0% for males (P<.001). After adjusting for confounders, male gender independently increased mortality risk (reference: females; adjusted hazard ratio 1.57; 95% confidence interval 1.32-1.86). Retrospective study. Males exhibited more aggressive pathologic features including greater Breslow thickness and higher ulceration and lymph node positivity rates. Male gender independently increased mortality risk.