title: Epidemiological trends and clinicopathological features of cutaneous melanoma in sporadic and xeroderma pigmentosum Tunisian patients.
abstract: BACKGROUND
  Epidemiological features and trends of cutaneous melanoma (CM) in North-African populations remain unclear. Those populations are of particular interest as they belong to a mosaic of various other origins (sub-Saharan, European Ancestry, and North-African Berbers). The aim of this study is to draw epidemiological profile and clinicopathological features of CM in the Tunisian population.
  
  
  METHODS
  Incidence analyses were based on data from regional cancer registries. Clinical data were collected from dermatological departments and xeroderma pigmentosum (XP) referral centers and provided CM clinicopathological characteristics and progression. Statistical analyses were achieved using R packages and SPSS 20.0.
  
  
  RESULTS
  The incidence of CM in Tunisia is relatively low (0.5-0.7 per 100,000 inhabitants per year). Gender differences were observed regarding anatomical distribution (P = 0.004). Acral lentiginous melanoma (ALM) was the most frequent histological subtype (32.3%); however, nodular melanoma (NM) was the most aggressive and responsible for 54.8% of deaths. CM in XP patients develops at a median age that is 42 years earlier than sporadic cases, with preferential localization on the head and neck (P < 0.001). Finally, male patients exhibited survival disadvantages compared with females (adjusted hazard ratio (HR) = 2.22, 95% CI: 1.05-4.68, P = 0.037).
  
  
  CONCLUSIONS
  Cutaneous melanoma features in Tunisia are closer to those of non-Caucasians, even though gender differences that are similar to those observed in Caucasians were uncovered. This study also emphasizes the aggressiveness of NM and its effect on melanoma patient deaths. Xeroderma pigmentosum stands as the major predisposing host factor.
authors: LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique, Université Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Chokri
authors: C
authors: Naouali
authors: Service de dermatologie, hôpital Charles Nicolle, Tunis, Tunisia.
authors: Meriem
authors: M
authors: Jones
authors: LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique, Université Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Imen
authors: I
authors: Nabouli
authors: LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique, Université Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Manel
authors: M
authors: Jerbi
authors: LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique, Université Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Haifa
authors: H
authors: Tounsi
authors: LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique, Université Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Mariem
authors: M
authors: Ben Rekaya
authors: LR11IPT02 Laboratoire de Transmission, Contrôle et Immunobiologie des Infections, Université de Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Melika
authors: M
authors: Ben Ahmed
authors: LR11IPT08 Laboratoire Venins et Biomolécules Thérapeutiques, Université de Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Balkiss
authors: B
authors: Bouhaouala
authors: LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique, Université Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Olfa
authors: O
authors: Messaoud
authors: Service de dermatologie, hôpital Charles Nicolle, Tunis, Tunisia.
authors: Aida
authors: A
authors: Khaled
authors: Service de dermatologie, hôpital Charles Nicolle, Tunis, Tunisia.
authors: Mohamed
authors: M
authors: Zghal
authors: LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique, Université Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Sonia
authors: S
authors: Abdelhak
authors: LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique, Université Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Samir
authors: S
authors: Boubaker
authors: LR11IPT05 Laboratoire de Génomique Biomédicale et Oncogénétique, Université Tunis El Manar, Institut Pasteur de Tunis, Tunis, Tunisia.
authors: Houda
authors: H
authors: Yacoub-Youssef
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D014416:Tunisia / Q000453:epidemiology; D014983:Xeroderma Pigmentosum / Q000453:epidemiology*