Survival and prognostic variables of cutaneous melanoma observed between 1995 and 2000 at Istituto Dermopatico Dell'Immacolata (IDI-IRCCS), Rome, Italy.
BACKGROUND
Melanoma is an increasingly common malignancy of melanocytes, with incidence rates steadily rising over the past several decades. The objective of this study was to evaluate 5-year survival and to investigate the association between melanoma mortality and clinical and histological features.


METHODS
We conducted a 5-year cohort study among 1020 patients from the same geographic area (Rome) with a single primary cutaneous melanoma diagnosed between January 1995 and December 2000. Survival probability was determined by Kaplan-Meier estimates, and prognostic factors were evaluated by multivariate analysis (Cox proportional hazards model).


RESULTS
Survival decreased with increasing age (P for trend <0.049) and Breslow thickness (P for trend <0.0001). In the multivariate Cox model, Breslow thickness was the only independent prognostic factor for mortality in primary melanoma patients. The risk of death among patients with melanoma increased with increasing tumour thickness 0.76-1.49 mm (relative risk (RR) 2.67, 95% confidence interval (95% CI) 0.63-11.4); 1.50-4.0 mm (RR 6.38, 95% CI 1.75-23.2), >4.0 mm (RR 34.6, 95% CI 8.23-145.7) (P for trend <0.0001). The Years of Life Lost (YLLs) for the Breslow categories < or =0.75 mm, 0.76-1.49 mm, 1.50-4.0 mm and >4.0 mm were 65.4, 153.6, 274.3 and 317.6 years, respectively.


CONCLUSIONS
This study shows the great importance of secondary melanoma prevention and illustrates how many years of life could be saved by early diagnosis.
Fortes
Cristina
C
Clinical Epidemiology Unit, Istituto Dermopatico Dell'Immacolata (IDI-IRCCS), Via dei Monti di Creta, 104, 00167 Rome, Italy. cfortes@idi.it
Mastroeni
Simona
S
Sera
Francesco
F
Concolino
Francesco
F
Abeni
Damiano
D
Melchi
Franco
F
Forastiere
Francesco
F
Pasquini
Paolo
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D016019:Survival Analysis