title: Malignant melanoma in Ferrara, Northern Italy: epidemiologic survey focusing on tumor thickness.
abstract: OBJECTIVE
  Estimates of malignant melanoma (MM) incidence and prognosis vary widely. The present study was performed to analyze epidemiologic and prognostic aspects of primary MM mainly in relation to tumor thickness.
  
  
  METHODS
  We conducted a retrospective study on a cohort of 435 patients with diagnosis of primary MM between 1997 and 2011.
  
  
  RESULTS
  In the period 2009-2011, among the MM diagnosed 50.00% were thin, 32.43% in situ and 17.57% thicker while in 1997-1999 MM>1 mm accounted for 51.61% of diagnoses. Mean age of patients affected with thin MM was significantly lower than that of patients with MM>1 mm, and mean thickness resulted significantly lower in female patients than in males. Mean thickness of MM located on easily self-evaluable body areas was significantly lower than in those not accessible for skin self-examination. The commonest histogenetic type was superficially spreading melanoma. Mitotic rate, ulceration and vertical growth phase all resulted related to MM thickness. Out of 61 patients with thin MM who underwent SLNB, 3 resulted positive (4.92%): neither thickness >0.75 mm, nor ulceration, mitotic rate or Clark level were found to be associated with SLNB positivity. Five-year survival rate was 98.3% for thin MM patients and 76.4% for thick MM patients.
  
  
  CONCLUSIONS
  Our trend analysis evidences a continuing increase of thinner primary MM throughout the study period, potentially enhancing patient prognosis. Regular skin self-examination could contribute to earlier recognition of MM. Identification of more powerful predictors of thin MM prognosis is necessary.
authors.affiliation: Section of Dermatology and Infective Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy - alessandro.borghi@unife.it.
authors.forename: A
authors.initials: A
authors.lastname: Borghi
authors.forename: M
authors.initials: M
authors.lastname: Corazza
authors.forename: S
authors.initials: S
authors.lastname: Minghetti
authors.forename: A
authors.initials: A
authors.lastname: Masarà
authors.forename: A
authors.initials: A
authors.lastname: Virgili
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000145:classification / Q000453:epidemiology* / Q000473:pathology / Q000556:secondary; D008875:Middle Aged; D008940:Mitotic Index; D009928:Organ Specificity; D012189:Retrospective Studies; D016353:Self-Examination; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology; D012883:Skin Ulcer / Q000209:etiology; D015996:Survival Rate; D055815:Young Adult; D000096142:Cutaneous Malignant Melanoma