title: Is sex an independent prognostic factor in cutaneous head and neck melanoma?
abstract: OBJECTIVE
  To determine if sex independently affects disease-specific survival (DSS) in patients with cutaneous head and neck melanoma.
  
  
  METHODS
  Retrospective analysis of a large population database.
  
  
  METHODS
  Our study included patients in the Surveillance, Epidemiology, and End Results database with cutaneous head and neck melanoma diagnosed from 2004 to 2009. Any cases with a history of previous malignancy or with multiple primaries were excluded. We obtained data on stage, race, age at diagnosis, radiological treatment status, and surgical treatment status. Our analysis consisted of a Kaplan-Meier analysis of DSS by sex [correction made here after initial online publication] that was supported by a multivariate Cox regression of all significant variables studied.
  
  
  RESULTS
  There were 13,507 patients identified with cutaneous head and neck melanoma who were diagnosed between 2004 and 2009. We observed that female patients had a better prognosis than their male counterparts, with 5-year DSS of 90.40% (95% confidence interval [CI], 89.03%-91.72%) and 87.10% (95% CI, 86.12%-88.08%), respectively. Multivariable analysis demonstrated a statistically significant decrease in disease-specific hazard ratio due to female sex independent of stage, treatment, age, or race.
  
  
  CONCLUSIONS
  Our study concludes that female sex is an independent prognostic factor for cutaneous head and neck melanoma. We demonstrated better 5-year DSS in female compared to male patients. Better prognosis could be due to multiple factors including differing hair, levels of sun exposure, and advanced male age.
  
  
  METHODS
  2b.
authors.affiliation: College of Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A.
authors.forename: Paolo M
authors.initials: PM
authors.lastname: Arce
authors.forename: P Ryan
authors.initials: PR
authors.lastname: Camilon
authors.forename: William A
authors.initials: WA
authors.lastname: Stokes
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Nguyen
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lentsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: Sex; cutaneous; disease-specific survival; head; melanoma; neck; survival analysis