title: Epidemiology, management and survival outcomes of primary cutaneous melanoma: a ten-year overview.
abstract: BACKGROUND
  Malignant melanoma (MM) is the most aggressive type of skin cancer, accounting for 90% of all the skin cancer mortality. The objective of this study was providing an overview of current patient- and tumour characteristics, treatment strategies, complications and survival in patients with MM over the past ten years. Hereby, an up-to-date view of every day clinical practice is obtained.
  
  
  METHODS
  Files of patients treated for primary cutaneous melanoma (n = 686) in the VieCuri Medical Centre in the Netherlands between January 2002 and December 2013 were retrospectively reviewed. Relevant patient features, tumour characteristics, and (surgical) outcomes were evaluated.
  
  
  RESULTS
  The majority of all the patients presented thin tumours (59.1% stage 1A/in situ melanoma). Men showed more ulceration (17.7% vs. 8.4%, p < .01) and a significantly higher Breslow thickness than women (1.2 mm vs. 0.9 mm, p < .01). 14.6% (40/273) underwent sentinel lymph node biopsy (SLNB); 10/40 (25%) showed nodal metastasis, 50 patients (7.3%) developed distant metastases (M: 10.6%, F: 5%, p < .01). One-, 5- and 10- year disease specific survival rates were 96%, 86% and 84%, respectively. Median survival for stage 4 MM was 3 months. Extensive surgery was uncommon (n = 3).
  
  
  CONCLUSIONS
  Patients generally presented with thin melanomas. Lymph node disease and distant metastases remained infrequently observed during following years, and general 1- and 5-year overall disease-specific survival rates exceeded 85%. Small numbers of rescue surgery and palliative medical treatment warrant further centralisation and investigation.
authors: a Department of Surgery , VieCuri Medical Centre Venlo , Venlo , The Netherlands.
authors: M M F
authors: MM
authors: Aubuchon
authors: a Department of Surgery , VieCuri Medical Centre Venlo , Venlo , The Netherlands.
authors: L J J
authors: LJ
authors: Bolt
authors: b Department of Clinical Epidemiology , VieCuri Medical Centre Venlo , Venlo , The Netherlands.
authors: M L G
authors: ML
authors: Janssen-Heijnen
authors: c Department of Dermatology , VieCuri Medical Centre Venlo , Venlo , The Netherlands.
authors: S T H P
authors: ST
authors: Verleisdonk-Bolhaar
authors: d Department of Pathology , VieCuri Medical Centre Venlo , Venlo , The Netherlands.
authors: A
authors: A
authors: van Marion
authors: a Department of Surgery , VieCuri Medical Centre Venlo , Venlo , The Netherlands.
authors: C L H
authors: CL
authors: van Berlo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D055815:Young Adult; D000096142:Cutaneous Malignant Melanoma
keywords: Melanoma; centralisation; sentinel lymph node; surgery