Melanoma

--Chang A, Karnell LJ, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma. Cancer 1998; 83:1664-1678. (!)

--Kemeny MM, Busch E, Stewart AK, Menck HR. Superior survival of young women with malignant melanoma. Am J Surg 1998; 175:437-44. (!)

For years, medical scientists have known that the overall survival outcome for women with malignant melanoma was superior to the outcome for men. No clear explanation exists for this difference. Female hormones may exert a protective effect against melanoma metastases. However, no clinical studies have been able to support this theory since no study has been large enough to analyze which independent variables may account for the difference. This study reports data on 23,000 patients diagnosed with melanoma between 1985 and 1988 who were reported to the National Cancer Data Base by hospital registries, and looks specifically at factors in women which could contribute to their improved survival. Emphasis is placed on age as a variable independent of other factors known to be important to survival such as stage, histology, or anatomic site. Age was used as a marker for hormonal status. There is little difference in the frequency distribution of malignant melanoma between men and women with respect to stage of disease or morphology. However, differences between the genders do appear with respect to the anatomic subsite of melanotic tumors. Overall, young women (45 years of age and under) enjoy superior survival rates when compared to older women (55 years of age and older) and men of any age. The survival advantage held by young women is particularly pronounced among patients diagnosed with advanced stage disease. These data suggest that hormonal factors may be critical in the superior survival rates seen among premenopausal women. Clinical trials designed to determine whether or not hormone treatment can inhibit the incidence of metastases should be initiated.

--Sutherland CM, Chmiel JS, Bieligk S, Henson DE, Winchester DP. Patient characteristics, treatment, and outcome of unknown primary melanom in the united states for the years 1981 and 1987. American Surgeon 1996;62:400-6. (!)

--Sutherland CM, Chmiel JS, Henson DE, Winchester DP. Patient characteristics, methods of diagnosis, and treatment of mucous membrane melanoma in the United States of America. J Am Coll Surg 1994; 179:561-566. (*)

Sixty patients diagnosed with mucous membrane melanoma in 1981 and 97 patients diagnosed in 1987 were submitted to the American College of Surgeons Patient Care Evaluation study of melanoma. These patients were generally older than patients with either skin or ocular melanoma. More females than males were reported, with no significant change between study years. Proportionally, more blacks were diagnosed with this condition than in previous studies of skin and ocular melanoma. The patients in this study had a poor prognosis based on characteristics known to be important for skin melanoma. As with skin melanoma patients, most patients with mucous membrane melanoma were treated with operation alone, but good results were infrequent in patients with mucous membrane melanoma. Local, regional, and systemic recurrences were significant problems and overall survival was poor.

--Urist MM, Karnell LH. The National Cancer Data Base report on melanoma. Cancer 1994; 74:782-788.

--Sutherland CM, Chmiel JS, Haik BG, Henson DE, Winchester DP. Patient characteristics, methods of evaluation, and treatment of ocular melanoma in the United States for the years 1981 and 1987. Surg Gynecol Obstet 1993; 177:497-503.

This report details the findings of 245 ocular melanomas diagnosed in 1981 and 275 diagnosed in 1987. Most of the ocular melanomas were uveal. The patients with ocular melanoma were older than the patients with skin melanoma. No significant difference was found in the number of ocular instances by gender and by study year. A high percentage of non-Hispanic whites were documented with this disease, and a high percentage of ocular melanomas were not classified by the standard Callender classification. A significant number of melanomas had pigmentation, and a significant number of patients had imaging studies that, in the absence of an elevated alkaline phosphatase, usually yielded negative results. Most patients were treated with enucleation, with an increase in frequency of radiation therapy from 1981 to 1987. Local and regional recurrence was not a problem, but systemic metastases occurred frequently. Type of histologic factors by the Callender classification had an influence on survival.

--Urist MM, Karnell LH. Melanoma. In: Steele GD, Winchester DP, Menck HR, Murphy GP: eds. National Cancer Data Base: Annual review of patient care, 1993. Atlanta, GA: American Cancer Society, 1993; 52-64.

--Sutherland CM, Chmiel JS, Henson DE, et al. Patient characteristics, methods of diagnosis, and treatment of melanoma in the United States. Surg Gynecol Obstet 1992; 175:129-134. (*)

--Balch CM, Karakousis C, Natarajan N, Donegan WL, Smart CR, Murphy GP. Management of cutaneous melanoma in the United States. Surg Gynecol Obstet 1984; 158:311-318. (*)

--Balch CM, Mettlin CJ. Melanoma in the United States: A national survey of 4800 patients. In: Balch CM, Milton GW, eds. Cutaneous melanoma. Clinical management and treatment results worldwide. Philadelphia, J.B.Lippincott Co., 1984; 389-395. (*)

--Mettlin CJ, Karakousis C, Natarajan N, Smart CR, Murphy GP. Recent patterns of malignant melanoma patient care in the United States. International Advances in Surgical Oncology 1984; 7:215-240.

--Balch CM, Mettlin CJ. Symptoms and treatment of melanoma in the United States. Bulletin of the American College of Surgeons 1982; 67:9-13. (*)

 

Clinical Infomation Bibliography