Abstract
BackgroundThe incidence of melanoma, one of the most aggressive of the skin cancers, has been increasing worldwide in the last few decades. Data from Latin America and Brazil remain scarce. We aimed to describe the demographic, clinical, and histopathological data; therapy characteristics; and survival rates of the Brazilian melanoma patient population.ResultsWe collected and analysed retrospective data from 15 years at a tertiary cancer centre. We describe patient characteristics and treatment. We calculated survival, and identified the main prognostic factors through univariate and multivariate analysis. We analysed a total of 1073 patients, with a mean age of 56.7 years. Men and women experienced similar prevalence, and 91.2% of patients had white skin. The most prevalent subtype was superficial spreading, and the most prevalent anatomic location was the trunk (32.2%), followed by the lower extremities (28%). Of all cases, 567 (52.9%) were assigned to clinical stages I and II, while 382 (32.6%) were stages III and IV. Surgery was the main treatment. Sentinel node biopsy was performed in 373 patients, with 23.8% positivity. Overall actuarial 5-year survival was 67.6%. Multivariate analysis showed that gender, serum lactate dehydrogenase (LDH) levels at diagnosis; anatomic location, TNM stage, and local recurrence were significant prognostic factors.ConclusionsOverall survival was lower than worldwide rates. The main factors influencing survival were similar to those in other populations. Local recurrence was independently associated with lower survival rates. The high prevalence of advanced cases reinforces the importance of strategies to diagnose melanomas in the early stages. There is a need for future multi-institutional prospective studies to attain a better understanding of possible socioeconomic and other influences on survival among melanoma populations in Brazil and Latin America.
Highlights
The incidence of melanoma, one of the most aggressive of the skin cancers, has been increasing worldwide in the last few decades
This study shows that Brazilian melanoma patients experienced a lower survival rate than the current worldwide average
Our findings confirm the strong association between TNM stage and local recurrence to prognosis
Summary
The incidence of melanoma, one of the most aggressive of the skin cancers, has been increasing worldwide in the last few decades. We aimed to describe the demographic, clinical, and histopathological data; therapy characteristics; and survival rates of the Brazilian melanoma patient population. Melanoma constitutes less than 5% of skin cancers but is responsible for around 95% of skin cancer deaths, and its incidence has been rising worldwide over recent decades [2]. In Brazil, it is estimated that 6000 new cases occur each year, resulting in 1300 deaths [3,4,5]. Risk factors for melanoma development include exposure to ultraviolet (UV) rays, as well as individual phenotypical characteristics, such as fair skin/hair pigmentation, presence of multiple nevi, immunosuppression, and family history [6]. The presence and characteristics of lymph nodes
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