BACKGROUND.Cutaneous soft tissue sarcomas (CSTS) are a heterogeneous group of mesenchymal neoplasms. To the authors' knowledge, no prior large, population‐based study has focused on CSTS.METHODS.Surveillance, Epidemiology, and End Results (SEER) Program incidence and relative survival rates of CSTS were analyzed according to race, sex, and histologic type using the 2002 criteria of the World Health Organization classification.RESULTS.Among residents of the 13 SEER registries, 12,114 CSTS were diagnosed from 1992 through 2004. Overall age‐adjusted CSTS incidence rates were highest among blacks (30.8 per 1,000,000 person‐years) followed by whites (25 per 1,000,000 person‐years), and American Indians/Alaska Natives (11.2 per 1,000,000 person‐years) and were lowest among Asian/Pacific Islanders (7.7 per 1,000,000 person‐years). Kaposi sarcoma (KS) accounted for 71.1% of cases, and the rates were similarly ranked. Dermatofibrosarcoma protuberans (DFSP) rates also were highest among blacks, whereas leiomyosarcoma (LS) and angiosarcoma (AS) rates were highest among whites. The rate ratio of men to women was 25.5 for KS, 4.7 for malignant fibrous histiocytoma (MFH), 3.7 for LS, 2.0 for AS, and 0.9 for DFSP. The 5‐year relative survival rates were 99% for patients with DFSP, 89% for patients with MFH, 92% for patients with LS, and 45% for patients with AS. KS rates among men in the original 9 SEER registries increased more than 30‐fold during the 1980s before they peaked around 1991 and subsequently declined rapidly because of human immunodeficiency virus‐associated KS and highly active antiretroviral therapy. This KS pattern was evident not only among those ages 20 to 59 years but also among those ages 60 to 69 years. From 1978 through 2004, LS and AS rates among whites increased exponentially.CONCLUSIONS.CSTS rates varied markedly over time and by race, sex, and histologic type, supporting the notion that these histologic variants of CSTS areetiologically distinct. Cancer 2008. © 2008 American Cancer Society.

Main Outcome Measures: Age-adjusted melanoma incidence and stage at diagnosis. Results: Of 41 072 cases of melanoma, 39 670 cases were reported for white non-Hispanics (WNHs), 1148 for white Hispanics (WHs), and 254 for blacks. Melanoma incidence rates increased by 3.0% per year among WNH men (PϽ .001), 3.6% among WNH women (PϽ .001), 3.4% among WH women (P = .01), and 0.9% among WH men (P =.52), while remaining relatively stable among black men and women. Both WHs and blacks had significantly more advanced melanoma at presentation: 18% of WH and 26% of black patients had either regional or distant-stage melanoma at diagnosis compared with 12% of WNH patients. The proportion of distant-stage melanoma diagnosed among WHs and blacks changed little from 1990 to 2004, compared with a steady decrease in the percentage of melanoma cases diagnosed at distant stage among WNHs (PϽ .001). Such differences in the time trends of the proportion of distant-stage melanoma remained after excluding in situ cases. Conclusions: The rising melanoma incidence among WNHs and WHs emphasizes the need for primary prevention. The persistence of disparity in melanoma stage at diagnosis among WHs, blacks, and WNHs warrants closer examination of secondary prevention efforts in minority groups.

More comprehensive medical training, expanded public educational campaigns, and increased awareness among patients of all skin types to perform self skin checks are recommended. Further studies elucidating the etiology and risk factors for melanoma among minority populations are warranted.

These findings, albeit limited in significance by the low number of cases and the retrospective nature of the study, confirm a probable role of TNF-α in the pathogenesis of vitiligo. The intensity of TNF-α staining in vitiligo lesions may be worth to be further studied as a biomarker for potentially successful anti-TNF-α treatment of nonsegmental vitiligo in cases refractory to conventional treatment.

Routine examination by primary care physicians frequently does not include a thorough skin examination. Physicians should be even more vigilant with patients at increased risk of excessive occupational sun exposure, as early detection of skin cancer by periodic skin examination decreases morbidity and can improve survival.

Tumor thicknesses ranged from 4.7 to 10.5 mm. Mitoses were rare. All tumors showed perineural invasion. None was associated with solar elastosis, vascular invasion, or satellites. Comment. Desmoplastic melanoma is an important subtype of melanoma because it represents a diagnostic pitfall and has a distinct clinical behavior. 1 It has a higher rate of local recurrence and lower incidence of sentinel lymph node involvement than conventional melanoma, especially if the DM is histopathologically pure in appearance. 2,3 It is of interest that the DMs of the 3 African American women described herein lacked an associated intraepidermal (in situ) melanoma component as well as evidence of solar elastosis, which suggests a cause independent of chronic sun damage. Most melanomas in African Americans are acral tumors or melanomas of superficial spreading type. Based on Surveillance, Epidemiology, and End Results (SEER) data (1992-2002), 7 of 251 primary invasive melanomas of African Americans were reported as desmoplastic. 4 However, they were not further characterized with regard to histopathologic subtype (pure vs mixed) or anatomic site. One case report of a tumor said to be desmoplastic was an acral melanoma. 5 After review of its histopathologic illustrations, we interpret it as a mixed DM. 5 Herein, we report for the first time to our knowledge the occurrence of pure DMs at nonacral sites in African American women.

To compare melanoma trends within Florida with national melanoma trends from 1992 through 2004. An analysis of state and national melanoma trends is critical for the identification of high-risk regions of the country. Design: Data from the Florida Cancer Data System (FCDS) and Surveillance, Epidemiology, and End Results (SEER) were evaluated to determine age-adjusted and race/ethnicity-and sex-specific invasive cutaneous melanoma incidence trends for 1992 through 2004 using joinpoint regression analysis. Standardized incidence rate ratios (SIRRs) were computed to compare Florida with the United States. Patients: A population of 109 633 patients with invasive melanoma was evaluated: 73 206 (66.8%) from SEER and 36 427 (33.2%) from FCDS. Main Outcome Measures: Melanoma incidence and change in melanoma rates over time. Results: The incidence of melanoma among male Hispanic patients residing in Florida was 20% higher than that of their male counterparts in the SEER catchment areas (SIRR, 1.2; 95% confidence interval [CI], 1.1-1.4). Conversely, the incidence of melanoma among female Hispanic patients residing in Florida was significantly lower than that in SEER (SIRR, 0.7; 95% CI, 0.7-0.8). Differences in melanoma incidence were identified in female non-Hispanic black (NHB) patients in Florida who had a 60% significantly higher incidence of melanoma compared with female NHB patients in SEER (SIRR, 1.6; 95% CI, 1.3-2.0). Conclusion: These findings suggest an emerging public health concern in race/ethnic subgroups that were previously understudied.

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