Prognostic parameters in localised melanoma: gender versus anatomical location.

Extremity location and female gender are both considered favourable prognostic parameters in primary melanoma, but since they cluster in the same group of patients, the question remains as to whether they are both independent variables. Multivariate analysis of 695 patients with primary, localised melanoma was used. The effects of gender and anatomical location were compared directly by sequentially controlling one factor while the other remained free. Following multivariate analysis, significant prognostic factors related to survival were the thickness of the primary lesion (P < 0.0001), the age of the patient at diagnosis (P < 0.0001), the gender of the patient (P = 0.0008) and the anatomical location of the primary lesion (P = 0.005). Thicker lesions, patients older than 50 years, males, and trunk, head and neck locations had poorer prognoses. There was a significant difference in survival according to gender within each location, extremity (P = 0.002) or trunk, head and neck (P = 0.0004); however, there was no significant difference in survival according to anatomical location within each gender, male (P = 0.11) or female (P = 0.29). The thickness of the primary lesion, the age of the patient at diagnosis, the gender and the anatomical location of the melanoma are all significant prognostic parameters in localised melanoma. Gender appears to have a more pronounced effect on survival than anatomical location.