Predictors of mucosal melanoma survival in a population-based setting

Abstract

Background: Mucosal melanomas are rare and aggressive neoplasms, with little published population-based data on predictors of survival. Objective: To assess the influences of race/ethnicity, sex, tumor stage, tumor thickness, and anatomic site on mucosal melanoma survival estimates. Methods: We analyzed 132,751 cases of melanoma, including 1,824 mucosal melanomas, diagnosed between 1994 and 2015 and reported to the California Cancer Registry. Kaplan-Meier survival analysis and Cox proportional hazards regression assessed the prognostic variables. Results: The 5-year relative survival for mucosal melanomas (27.64%, 95% confidence interval [CI] 25.42-29.91) was significantly lower than for cutaneous melanomas (76.28%, 95% CI 76.03-76.53). Stage independently influenced survival, and thickness did not predict survival for neoplasms of known depth. Less common anatomic sites conferred worse prognoses (hazard ratio [HR] 1.93, 95% CI: 1.41-2.64). Limitations: Lack of a standardized staging system may have resulted in misclassification of stage for some neoplasms. The influence of genetics is unknown because our database did not contain genetic characteristics. Conclusions: Stage and anatomic site, but not thickness (i.e. Breslow depth), race, or ethnicity, determine prognosis of mucosal melanomas. Considering the poor prognosis for all stages of

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“…9 Nevertheless, it is known that mucosal melanomas have a worse prognosis than cutaneous melanomas regardless of the stage. 15 Male gender, tumour thickness, age, ulceration and advanced tumour stage at initial diagnosis are linked to a less favourable prognosis for mucosal melanoma. [14][15][16][17][18][19][20][21] In the current study, age ≥60, anorectal localization, thickness and advanced tumour stage were identified as significant negative prognostic factors for survival according to the univariate analysis.…”

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