Maximilian Gassenmaier1, Ulrike Keim2, Ulrike Leiter2, Thomas K Eigentler2, Martin Röcken3, Anja Gesierich4, Rose K C Moritz5, Lucie Heinzerling6, Thomas Tüting7, Uwe Wollina8, Claus Garbe2. 1. Department of Dermatology, Eberhard-Karls-University of Tübingen, Tübingen, Germany. Electronic address: maximilian.gassenmaier@med.uni-tuebingen.de. 2. Center for Dermatooncology, Department of Dermatology, Eberhard-Karls-University of Tübingen, Tübingen, Germany. 3. Department of Dermatology, Eberhard-Karls-University of Tübingen, Tübingen, Germany. 4. Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany. 5. Department of Dermatology and Venereology, University Hospital and Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany. 6. Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany. 7. Department of Dermatology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany. 8. Städtisches Klinikum Dresden, Standort Friedrichstadt, Klinik für Dermatologie und Allergologie, Dresden, Germany.
Abstract
BACKGROUND: Melanoma incidence rates rise as people age, but the impact of aging on distant metastasis is unclear. OBJECTIVE: To investigate how timing, pattern, and extent of distant metastasis is influenced by age. METHODS: Analysis of a single-center cohort of 1457 patients of the German Central Malignant Melanoma Registry with prospectively documented follow-up. Findings were compared with those for 1682 patients from 5 different institutions. All patients presented initially with stage IA to IIC and developed distant metastasis in their further disease course. RESULTS: The number of metastatic sites decreased with increasing age at melanoma diagnosis (P < .001). The rate of stage M1d disease decreased from 50.2% in patients aged 50 years or younger to 30.1% in patients older than 70 years, and the rate of stage M1b disease increased from 5.8% to 21.5%. The rate of lung metastases remained stable in all investigated age groups (P = .54). Distant metastases occurred earlier and were more synchronized in patients older than 70 years than in patients aged 50 years or younger. An age-dependent decrease in metastatic sites and stable rate of lung metastasis were found and confirmed by data on the multi-institutional cohort. LIMITATIONS: The study was not population based. CONCLUSION: Pattern, timing, and extent of distant metastasis change as people age. These findings may be considered when treating patients with melanoma of different ages.
BACKGROUND:Melanoma incidence rates rise as people age, but the impact of aging on distant metastasis is unclear. OBJECTIVE: To investigate how timing, pattern, and extent of distant metastasis is influenced by age. METHODS: Analysis of a single-center cohort of 1457 patients of the German Central Malignant Melanoma Registry with prospectively documented follow-up. Findings were compared with those for 1682 patients from 5 different institutions. All patients presented initially with stage IA to IIC and developed distant metastasis in their further disease course. RESULTS: The number of metastatic sites decreased with increasing age at melanoma diagnosis (P < .001). The rate of stage M1d disease decreased from 50.2% in patients aged 50 years or younger to 30.1% in patients older than 70 years, and the rate of stage M1b disease increased from 5.8% to 21.5%. The rate of lung metastases remained stable in all investigated age groups (P = .54). Distant metastases occurred earlier and were more synchronized in patients older than 70 years than in patients aged 50 years or younger. An age-dependent decrease in metastatic sites and stable rate of lung metastasis were found and confirmed by data on the multi-institutional cohort. LIMITATIONS: The study was not population based. CONCLUSION: Pattern, timing, and extent of distant metastasis change as people age. These findings may be considered when treating patients with melanoma of different ages.
Authors: Mallory J DiVincenzo; Nicholas Latchana; Zachary Abrams; Maribelle Moufawad; Kelly Regan-Fendt; Nicholas B Courtney; J Harrison Howard; Alejandro A Gru; Xiaoli Zhang; Paolo Fadda; William E Carson Journal: Melanoma Res Date: 2020-10 Impact factor: 3.199