Cutaneous melanoma in older patients
Abstract Background In industrialized countries, the aging population is steadily rising. The incidence of cutaneous malignant melanoma (CMM) is highest in old people. This study focuses on the clinicopathological profile of CMM and indicators of diagnostic-therapeutic performance in older patients....
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-024-04806-8 |
| _version_ | 1827321330426445824 |
|---|---|
| author | Alessandra Buja Massimo Rugge Chiara Trevisiol Anna Zanovello Alessandra Rosalba Brazzale Manuel Zorzi Antonella Vecchiato Paolo Del Fiore Saveria Tropea Marco Rastrelli Carlo Riccardo Rossi Simone Mocellin |
| author_facet | Alessandra Buja Massimo Rugge Chiara Trevisiol Anna Zanovello Alessandra Rosalba Brazzale Manuel Zorzi Antonella Vecchiato Paolo Del Fiore Saveria Tropea Marco Rastrelli Carlo Riccardo Rossi Simone Mocellin |
| author_sort | Alessandra Buja |
| collection | DOAJ |
| description | Abstract Background In industrialized countries, the aging population is steadily rising. The incidence of cutaneous malignant melanoma (CMM) is highest in old people. This study focuses on the clinicopathological profile of CMM and indicators of diagnostic-therapeutic performance in older patients. Methods This retrospective population-based cohort study included 1,368 incident CMM, as recorded in 2017 by the Regional Veneto Cancer Registry (Northeast Italy). Older subjects were defined as ≥ 80, old as 65–79, and adults as < 65 years of age. The strength of association between pairs of variables was tested by Cramer’s-V. Using age groups as the dependent variable, ordered logistic regression was fitted using the clinicopathological CMM profiles as covariates. In each of the three age-groups, the indicators of clinical performance were computed using the Clopper-Pearson exact method. Results Compared to patients aged younger than 80 years (1,187), CMM in older patients (181; 13.2%) featured different CMM topography, a higher prevalence of ulcers (43.3% versus 12.7%; p < 0.001), a higher Breslow index (p < 0.001), a lower prevalence of tumor-infiltrating lymphocytes (64.4% versus 76.5%, p < 0.01), and a more advanced pTNM stage at clinical presentation (p < 0.001). Elderly patients with a positive sentinel-lymph node less frequently underwent sentinel- lymph node biopsy and lymphadenectomy (60.0% versus 94.2%, and 44.4% versus 85.5%, respectively; p < 0.001). Conclusions In older CMM patients, the clinicopathological presentation of CMM shows a distinctive profile. The present results provide critical information to optimize secondary prevention strategies and refine diagnostic-therapeutic procedures tailored to older patients. |
| first_indexed | 2024-04-25T01:04:24Z |
| format | Article |
| id | doaj.art-f5835a5143e84f359d249e319a328d5a |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-25T01:04:24Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-f5835a5143e84f359d249e319a328d5a2024-03-10T12:21:40ZengBMCBMC Geriatrics1471-23182024-03-012411810.1186/s12877-024-04806-8Cutaneous melanoma in older patientsAlessandra Buja0Massimo Rugge1Chiara Trevisiol2Anna Zanovello3Alessandra Rosalba Brazzale4Manuel Zorzi5Antonella Vecchiato6Paolo Del Fiore7Saveria Tropea8Marco Rastrelli9Carlo Riccardo Rossi10Simone Mocellin11Hygiene and Public Health Unit, Laboratory of Health Care Services and Health Promotion Evaluation, Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, University of PaduaPathology and Cytopathology Unit, Department of Medicine - DIMED, University of PaduaSoft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCSHygiene and Public Health Unit, Laboratory of Health Care Services and Health Promotion Evaluation, Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, University of PaduaDepartment of Statistical Sciences, University of PaduaVeneto Tumour Registry (RTV)Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCSSoft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCSSoft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCSSoft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCSDepartment of Surgery, Oncology and Gastroenterology - DISCOG, University of PaduaSoft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV-IRCCSAbstract Background In industrialized countries, the aging population is steadily rising. The incidence of cutaneous malignant melanoma (CMM) is highest in old people. This study focuses on the clinicopathological profile of CMM and indicators of diagnostic-therapeutic performance in older patients. Methods This retrospective population-based cohort study included 1,368 incident CMM, as recorded in 2017 by the Regional Veneto Cancer Registry (Northeast Italy). Older subjects were defined as ≥ 80, old as 65–79, and adults as < 65 years of age. The strength of association between pairs of variables was tested by Cramer’s-V. Using age groups as the dependent variable, ordered logistic regression was fitted using the clinicopathological CMM profiles as covariates. In each of the three age-groups, the indicators of clinical performance were computed using the Clopper-Pearson exact method. Results Compared to patients aged younger than 80 years (1,187), CMM in older patients (181; 13.2%) featured different CMM topography, a higher prevalence of ulcers (43.3% versus 12.7%; p < 0.001), a higher Breslow index (p < 0.001), a lower prevalence of tumor-infiltrating lymphocytes (64.4% versus 76.5%, p < 0.01), and a more advanced pTNM stage at clinical presentation (p < 0.001). Elderly patients with a positive sentinel-lymph node less frequently underwent sentinel- lymph node biopsy and lymphadenectomy (60.0% versus 94.2%, and 44.4% versus 85.5%, respectively; p < 0.001). Conclusions In older CMM patients, the clinicopathological presentation of CMM shows a distinctive profile. The present results provide critical information to optimize secondary prevention strategies and refine diagnostic-therapeutic procedures tailored to older patients.https://doi.org/10.1186/s12877-024-04806-8MelanomaAgeOldHistopathological characteristicsClinical indicatorsCohort study |
| spellingShingle | Alessandra Buja Massimo Rugge Chiara Trevisiol Anna Zanovello Alessandra Rosalba Brazzale Manuel Zorzi Antonella Vecchiato Paolo Del Fiore Saveria Tropea Marco Rastrelli Carlo Riccardo Rossi Simone Mocellin Cutaneous melanoma in older patients BMC Geriatrics Melanoma Age Old Histopathological characteristics Clinical indicators Cohort study |
| title | Cutaneous melanoma in older patients |
| title_full | Cutaneous melanoma in older patients |
| title_fullStr | Cutaneous melanoma in older patients |
| title_full_unstemmed | Cutaneous melanoma in older patients |
| title_short | Cutaneous melanoma in older patients |
| title_sort | cutaneous melanoma in older patients |
| topic | Melanoma Age Old Histopathological characteristics Clinical indicators Cohort study |
| url | https://doi.org/10.1186/s12877-024-04806-8 |
| work_keys_str_mv | AT alessandrabuja cutaneousmelanomainolderpatients AT massimorugge cutaneousmelanomainolderpatients AT chiaratrevisiol cutaneousmelanomainolderpatients AT annazanovello cutaneousmelanomainolderpatients AT alessandrarosalbabrazzale cutaneousmelanomainolderpatients AT manuelzorzi cutaneousmelanomainolderpatients AT antonellavecchiato cutaneousmelanomainolderpatients AT paolodelfiore cutaneousmelanomainolderpatients AT saveriatropea cutaneousmelanomainolderpatients AT marcorastrelli cutaneousmelanomainolderpatients AT carloriccardorossi cutaneousmelanomainolderpatients AT simonemocellin cutaneousmelanomainolderpatients |