Melanoma survival in the United States, 1992 to 2005.
BACKGROUND
Population-based data on melanoma survival are important for understanding the impact of demographic and clinical factors on prognosis.


OBJECTIVE
We describe melanoma survival by age, sex, race/ethnicity, stage, depth, histology, and site.


METHODS
Using Surveillance, Epidemiology, and End Results data, we calculated unadjusted cause-specific survival up to 10 years from diagnosis for 68,495 first primary cases of melanoma diagnosed from 1992 to 2005. Cox multivariate analysis was performed for 5-year survival. Data from 1992 to 2001 were divided into 3 time periods to compare stage distribution and differences in stage-specific 5-year survival over time.


RESULTS
Melanomas that had metastasized (distant stage) or were thicker than 4.00 mm had a poor prognosis (5-year survival: 15.7% and 56.6%). The 5-year survival for men was 86.8% and for persons given the diagnosis at age 65 years or older was 83.2%, varying by stage at diagnosis. Scalp/neck melanoma had lower 5-year survival (82.6%) than other anatomic sites; unspecified/overlapping lesions had the least favorable prognosis (41.5%). Nodular and acral lentiginous melanomas had the poorest 5-year survival among histologic subtypes (69.4% and 81.2%, respectively). Survival differences by race/ethnicity were observed in the unadjusted survival, but nonsignificant in the multivariate analysis. Overall 5-year melanoma survival increased from 87.7% to 90.1% for melanomas diagnosed in 1992 through 1995 compared with 1999 through 2001, and this change was not clearly associated with a shift toward localized diagnosis.


CONCLUSIONS
Prognostic factors included in revised melanoma staging guidelines were not available for all study years and were not examined.


CONCLUSIONS
Poorer survival from melanoma was observed among those given the diagnosis at late stage and older age. Improvements in survival over time have been minimal. Although newly available therapies may impact survival, prevention and early detection are relevant to melanoma-specific survival.
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Lori A
LA
Pollack
Jun
J
Li
Zahava
Z
Berkowitz
Hannah K
HK
Weir
Xiao-Cheng
XC
Wu
Umed A
UA
Ajani
Donatus U
DU
Ekwueme
Chunyu
C
Li
Brian P
BP
Pollack
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000209:etiology / Q000401:mortality* / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012042:Registries / Q000706:statistics & numerical data; D018426:SEER Program / Q000706:statistics & numerical data; D012737:Sex Factors; D012878:Skin Neoplasms / Q000209:etiology / Q000401:mortality* / Q000473:pathology; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D055815:Young Adult