The incidence and mortality of cutaneous melanoma in southern Germany

Abstract

BACKGROUND Cutaneous melanoma (CM) incidence and mortality have risen dramatically during the past 2 generations, particularly among Caucasian populations. Detailed, long‐term trends of CM in relation to clinical and pathologic characteristics in a Central European population have not been published to date. METHODS The current study was based on 1980 patients with invasive CM diagnosed in Southern Germany during the years from 1976 to 2003 documented by the Central Malignant Melanoma Registry. The German standard population was used to calculate age‐standardized rates, and the annual percent change was estimated by using age, anatomic site, histologic type, and tumor thickness. RESULTS During the study period, the incidence of CM approximately was tripled for males and females, reaching 10.3 and 13.3 per 100,000 per year, respectively (P < .001). The largest increases occurred for melanoma localized on the upper limbs (annual change, 5.9% for males and 5.0% for females; P < .001) and superficially spreading melanoma (annual change, 7.8% for males and 5.9% for females; P < .001). Thin tumors (Breslow thickness <1 mm) were presented significantly more often during the study period (annual change, 9.8% for males and 6.1% for females; P < .001), predominantly in younger patients. Thick tumors and nodular melanomas were more frequent among older patients (age >70 years), particularly among males. The age‐standardized mortality decreased from 1.5 to 0.8 per 100,000 males and from 2.6 to 0.8 per 100,000 females with a significant downward trend for the female population (P < .001). CONCLUSIONS The current results indicated which diverging trends between incidence and mortality may be explained by improved public awareness regarding suspicious pigmented lesions and the earlier detection of these tumors. Continuation of the current preventive strategy and its expansion to include older age groups in the population are warranted. Cancer 2006. © 2006 American Cancer Society.

Caspase-3 cleaves XIAP in a positive feedback loop to sensitize melanoma cells to TRAIL-induced apoptosis

“…Malignant melanoma represents one of the most aggressive malignancies with a highly chemoresistant and radioresistant metastatic stage (Flaherty, 2006), offering a poor prognosis for affected patients (Lasithiotakis et al, 2006). Therefore, therapeutic strategies combining chemotherapeutic drugs and tumor selective death ligands are under investigation to improve cancer treatment (Ganten et al, 2006;Zhang et al, 2006;Koschny et al, 2007).…”

Sensitization of melanoma cells to TRAIL by UVB-induced and NF-κB-mediated downregulation of xIAP

“…Malignant melanoma represents a malignancy with most rapidly increasing incidences offering a poor prognosis for patients with metastatic disease (Lasithiotakis et al, 2006). Melanomas develop and progress in a sequence of defined stages from nevic lesions or normal cells (Meier et al, 1998).…”

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

“…[1][2][3] Since the mid-1980s, however, the rates of increase began decreasing or at least leveling off. [4][5][6][7][8][9] Recent studies showed that the observed leveling-off in rates predominantly occurred in younger persons and the patterns showed positive effects for cohorts born after 1945 or 1950.…”

“…4,6,9 Conversely, the rate of increase in melanoma incidence and mortality has been significantly higher for age groups older than 60 years in Europe, the US, and Australia. [1][2][3][4] Older persons present more frequently with advanced tumors, lentigo malignant melanomas (LMM), and melanomas arising in sun-exposed anatomic areas and the disease-specific survival (DSS) of melanoma patients over 60 years old is significantly shorter compared with younger ages. 10 Thus, age seems to be a significant prognostic factor for melanoma and its prognostic significance has been demonstrated likewise after adjusting for all known prognostic variables such as tumor thickness, ulceration, etc.…”