Prognosis of melanoma in Peru: An analysis of 410 cases.

Abstract

e20023 Background: Little is known of the status of melanoma in developing countries. Our retrospective study was performed to determine the clinical characteristics and outcome of patients with melanoma in Peru. Methods: All cases with a pathological diagnosis of malignant melanoma from our institution between January 2002 and December 2011 were identified. Clinical data were extracted through retrospective chart review. Patients’ characteristics are presented using descriptive statistics. Survival curves were estimated using the Kaplan-Meier method. Univariate and multivariate analyses were evaluated using log-rank and Cox proportional-hazard regression tests, respectively. Results: A total of 410 cases were evaluated. The median age at presentation was 66 years (range 4-97 years) with a male-to-female ratio was 1.1:1. There were 146 cases (35.6%) of acral lentiginous melanoma, 67 (16.3%) of nodular melanoma, 54 (16.3%) of mucosal melanoma, 39 (9.5%) of superficial spreading melanoma, 55 (13.4%) were lentigo maligno and 49 (12.0%) were unclassifiable. Melanoma of unknown primary occurred in 34 (8.3%) of cases. The proportion of patients with stage I, II, III and IV disease were 24.2%, 24.8%, 21.9% and 7.8%, respectively. Ulceration status of 320 cases of cutaneous melanoma was recorded and 138 (45.1%) had ulceration. The 5-year survival rate of 409 patients was 58.4% with a median survival time of 7.6 years. The 5-year survival rates of patients with stage I, II, III and IV disease were 88.2%, 67.8%, 39.3% and 17.8% respectively (p<0.001). Univariate analysis showed age >65 years (p=0.003), male sex (p=0.0001), stage (p<0.001), nodular histology type (p<0.001), ulceration (p<0.001), Breslow thickness (p<0.001), Clark level (p<0.001) and localization (mucosal vs. cutaneous) (p<0.001) were associated with survival. In the multivariate analysis, stage was associated with worst prognosis (p=0.01), while other factors had no statistical correlation with survival. Conclusions: Based on our report, acral lentiginous melanoma is the most common type of malignant melanoma in Peruvian patients, and clinical stage was the only independent prognostic factor associated with survival.