Melanoma of the Upper Limb and Shoulder: A Surveillance, Epidemiology, and End Results Analysis of Epidemiology and Survival 2000–2019
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. Variable Selection
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Upper Limb and Shoulder n (%) | Other Sites n (%) | p-Value | Total n (%) | |
---|---|---|---|---|
Total | 69,436 (100) | 204,794 (100) | 274,230 (100) | |
Age at diagnosis [years] | <0.005 | |||
Mean (SD) | 60.00 (15.7) | 58.86 (16.9) | ||
Median | 61 | 60 | ||
Age group | <0.005 | |||
≤50 | 18,563 (26.7) | 63,946 (31.2) | 82,509 (30.1) | |
51–61 | 17,484 (25.2) | 49,863 (24.3) | 67,347 (24.6) | |
62–71 | 16,311 (23.5) | 43,435 (21.2) | 59,746 (21.8) | |
≥72 | 17,078 (24.6) | 47,550 (23.2) | 64,628 (23.6) | |
Gender | <0.005 | |||
Male | 35,267 (50.8) | 118,654 (57.9) | 153,921 (56.1) | |
Female | 34,169 (49.2) | 86,140 (42.1) | 120,309 (43.9) | |
Ethnicity | <0.005 | |||
White | 65,287 (94) | 192,416 (94) | 257,703 (94) | |
Black | 167 (0.2) | 1024 (0.5) | 1191 (0.4) | |
Asian or Pacific Islander | 333 (0.5) | 1513 (0.7) | 1846 (0.7) | |
American Indian/Alaska Native | 164 (0.2) | 522 (0.3) | 686 (0.3) | |
Unknown | 3485 (5.0) | 9319 (4.6) | 12,804 (4.7) | |
Year of Diagnosis (%) | <0.005 | |||
2000–2004 | 13,613 (19.6) | 42,737 (20.9) | (20.6) | |
2005–2009 | 16,546 (23.8) | 49,278 (24.2) | 65,824 (24) | |
2010–2014 | 18,650 (26.9) | 53,957 (26.4) | 72,607 (26.5) | |
2015–2019 | 20,627 (29.7) | 58,822 (28.7) | 79,449 (29) | |
Histologic Subtypes (%) | <0.005 | |||
8720/3: Malignant Melanoma, NOS | 33,643 (48.5) | 103,084 (50.3) | 136,727 (49.9) | |
8743/3: Superficial Spreading Melanoma | 23,479 (33.8) | 64,158 (31.3) | 87,637 (32) | |
8721/3: Nodular Melanoma | 5361 (7.7) | 1363 (6.7) | 18,999 (6.9) | |
8742/3: Lentigo Maligna Melanoma | 3787 (5.5) | 13,289 (6.5) | 17,076 (6.2) | |
8772/3: Spindle cell melanoma, NOS | 724 (1) | 2076 (1) | 2800 (1) | |
8745/3: Desmoplastic melanoma, malignant | 689 (1) | 2173 (1.1) | 2862 (1) | |
8744/3: Acral lentiginous melanoma, malignant | 471 (0.7) | 2270 (1.1) | 2741 (1) | |
8730/3: Amelanotic melanoma | 303 (0.4) | 707 (0.4) | 1010 (0.4) | |
8723/3: Malignant melanoma, regressing | 299 (0.4) | 890 (0.4) | 1189 (0.4) | |
8761/3: Malignant melanoma in giant pigmented nevus | 204 (0.3) | 727 (0.4) | 931 (0.3) | |
8740/3: Malignant melanoma in junctional nevus | 194 (0.3) | 677 (0.3) | 871 (0.3) | |
8771/3: Epithelioid cell melanoma | 135 (0.2) | 506 (0.2) | 641 (0.2) | |
8770/3: Mixed epithelioid and spindle cell melanoma | 113 (0.2) | 470 (0.2) | 583 (0.2) | |
8722/3: Balloon Cell Melanoma | 18 (0.03) | 67 (0.03) | 85 (0.03) | |
8780/3: Blue nevus, malignant | 10 (0.01) | 27 (0.01) | 37 (0.01) | |
8741/3: Malignant melanoma in precancerous melanosis | 4 (0.01) | 12 (0.01) | 16 (0.01) | |
8727/3: Dysplastic nevus, malignant | 1 (0.00) | 0 (0.00) | 1 (0.0) | |
8773/3: Spindle cell melanoma, type A | 1 (0.00) | 7 (0.00) | 1 (0.0) | |
Stage (%) | <0.005 | |||
Localized | 61,135 (88.02) | 166,042 (81.1) | 227,177 (82.8) | |
Regional | 4725 (6.8) | 19,343 (9.5) | 24,068 (8.8) | |
Distant | 767 (1.1) | 9900 (4.8) | 10,667 (3.9) | |
Other/not specified | 2809 (4.1) | 9509 (4.6) | 12,318 (4.5) | |
Type of Surgery (%) | <0.005 | |||
No Surgery or Radiation | 3425 (4.9) | 16,265 (7.9) | 19,690 (7.2) | |
Radiation Only | 399 (0.6) | 1183 (0.6) | 1582 (0.6) | |
Surgery with Radiation | 739 (1.1) | 2403 (1.2) | 3142 (1.1) | |
Surgery without Radiation | 64,617 (93.1) | 184,329 (90.0) | 248,946 (90.8) | |
Other/Not specified | 256 (0.4) | 614 (0.3) | 870 (0.3) | |
Reason for no surgery (%) | <0.005 | |||
Not recommended | 2341 (3.4) | 14,886 (7.3) | 17,227 (6.3) | |
Recommended but not performed; patient refused | 39 (0.1) | 217 (0.1) | 217 (0.1) | |
Recommended but not performed, unknown reason | 474 (0.7) | 1879 (0.9) | 1879 (0.9) | |
Not performed; patient died prior to recommended surgery | 7 (0.01) | 31 (0.02) | 38 (0.01) | |
Recommended, unknown if performed | 185 (0.3) | 575 (0.3) | 760 (0.3) | |
Not recommended, contraindicated due to other cond; autopsy only (1973–2002) | 10 (0.01) | 183 (0.1) | 193 (0.1) | |
Surgery performed | 66,208 (95.4) | 186,428 (91.0) | 252,636 (92.1) | |
Unknown; death certificate; or autopsy only (2003+) | 172 (0.3) | 595 (0.3) | 767 (0.3) | |
Lymph Node Removal | <0.005 | |||
No Regional Lymph Nodes Removed | 59,877 (86.2) | 174,517 (85.2) | 234,394 (85.5) | |
Regional Lymph Nodes Removed | 4244 (6.1) | 14,939 (5.4) | 19,183 (7.0) | |
Sentinel Nodes Removed | 4653 (6.7) | 12,692 (4.6) | 17,345 (6.3) | |
Unknown | 662 (1.0) | 2646 (1.0) | 3308 (1.2) | |
Ulceration 1 | <0.005 | |||
Ulceration not identified | 32,548 (46.87) | 88,395 (43.16) | 120,943 (44.10) | |
Ulceration present | 4686 (6.71) | 13,853 (6.76) | 18,509 (6.75) | |
Not documented | 32,323 (46.42) | 102,546 (50.07) | 134,778 (49.15) | |
Breslow Thickness (mm) 1 | <0.005 | |||
<0.8 mm | 21,773 (59.0) | 58,615 (58.5) | 80,388 (58.6) | |
0.8 to 1 mm | 4212 (11,4) | 11,603 (11.0) | 15,275 (11.1) | |
>1 to 2 mm | 5398 (14.6) | 14,265 (14.2) | 19,663 (14.3) | |
>2 to 4 mm | 3113 (8.4) | 8845 (8.8) | 11,958 (8.7) | |
>4 mm | 2384 (6.5) | 7465 (7.4) | 9849 (7.2) | |
No mass found | 29 (0.1) | 2601 (2.5) | 2630 (1.9) |
Upper Limbs & Shoulders | Other Sites | |||||||
---|---|---|---|---|---|---|---|---|
≤50 | 51–61 | 62–71 | ≥72 | ≤50 | 51–61 | 62–71 | ≥72 | |
Gender (%) | ||||||||
Female | 11,280 (33.0) | 8372 (24.5) | 6954 (20.4) | 7563 (22.1) | 35,211 (40.9) | 19,449 (22.6) | 14,537 (16.9) | 16,943 (19.7) |
Male | 7283 (20.7) | 9112 (25.8) | 9357 (26.5) | 9515 (27.9) | 28,735 (24.2) | 30,414 (25.6) | 28,898 (24.4) | 30,607 (25.8) |
Histological Subtypes (%) | ||||||||
Malignant Melanoma | 9252 (27.5) | 8529 (25.4) | 7810 (23.2) | 8052 (23.9) | 32,145 (31.2) | 23,393 (24.6) | 21,872 (21.2) | 23,674 (23.0) |
Superficial Spreading Melanoma | 266 (7.0) | 765 (20.2) | 1205 (31.8) | 1551 (41.0) | 1208 (9.1) | 2544 (19.1) | 2963 (21.7) | 4285 (31.4) |
Nodular Melanoma | 1029 (19.2) | 1184 (22.1) | 1181 (22.0) | 1967 (36.7) | 3239 (23.7) | 3151 (23.1) | 2963 (21.7) | 4285 (31.4) |
Lentigo Melanoma | 0 (0.0) | 1 (25.0) | 1 (25.0) | 2 (50.0) | 5 (41.7) | 2 (16.7) | 2 (16.7) | 3 (25.0) |
Spindle Cell Melanoma | 43 (38.1) | 15 (13.3) | 27 (23.9) | 28 (24.8) | 183 (38.9) | 96 (20.4) | 78 (16.6) | 113 (24.0) |
Cause of death (%) | ||||||||
Dead attributable to causes other than melanoma | 437 (4.4) | 1001 (10.0) | 2095 (20.9) | 6468 (64.7) | 1400 (5.2) | 2908 (10.8) | 5450 (20.2) | 17,260 (63.9) |
Dead attributable to melanoma | 843 (19.2) | 880 (20.0) | 1010 (23.0) | 1665 (37.9) | 4761 (20.7) | 5240 (22.8) | 5116 (22.3) | 7863 (34.2) |
Other (alive/unknown) | 17,283 (31.4) | 15,603 (28.4) | 13,206 (24.0) | 8945 (16.3) | 57,785 (37.3) | 41,715 (26.9) | 32,869 (21.2) | 22,427 (14.5) |
95%CI for Exp(B) | |||||
---|---|---|---|---|---|
B | Sig | Exp (B) | Lower | Upper | |
Age at diagnosis a | |||||
≤50 | |||||
51–61 | 0.611 | <0.005 | 1.822 | 1.788 | 1.898 |
62–71 | 1.197 | <0.005 | 3.310 | 3.217 | 3.405 |
≥72 | 2.265 | <0.005 | 9.629 | 9.386 | 9.879 |
Gender b | |||||
Female | |||||
Male | 0.322 | <0.005 | 1.380 | 1.357 | 1.402 |
Main histological Subtypes c | |||||
8720/3: Malignant Melanoma | |||||
8743/3: Superficial Spreading Melanoma | −0.320 | <0.005 | 0.726 | 0.704 | 0.749 |
8721/3: Nodular Melanoma | 0.648 | <0.005 | 1.912 | 1.867 | 1.959 |
8742/3: Lentigo Maligna Melanoma | 0.319 | 0.435 | 1.375 | 0.618 | 3.061 |
8772/3: Spindle Cell Melanoma | 0.379 | <0.005 | 1.460 | 1.272 | 1.677 |
Other | −0.290 | <0.005 | 0.748 | 0.735 | 0.762 |
Stage d | |||||
Localized | |||||
Regional | 0.581 | <0.005 | 1.789 | 1.690 | 1.893 |
Distant | 1.622 | <0.005 | 5.063 | 4.655 | 5.506 |
Treatment sequence e | |||||
Surgery with radiotherapy | |||||
Surgery without radiotherapy | −0.461 | <0.005 | 0.630 | 0.591 | 0.672 |
No surgery with radiotherapy | 0.500 | <0.005 | 1.649 | 1.531 | 1.776 |
No surgery without radiotherapy | −0.125 | <0.005 | 0.883 | 0.827 | 0.942 |
Breslow f | |||||
<0.8 mm | |||||
0.8 to 1 mm | 0.224 | <0.005 | 1.251 | 1.162 | 1.348 |
>1 to 2 mm | 0.656 | <0.005 | 1.927 | 1.823 | 2.037 |
>2 to 4 mm | 1.085 | <0.005 | 2.960 | 2.799 | 3.131 |
>4 mm | 1.722 | <0.005 | 5.594 | 5.295 | 5.911 |
Ulceration f | |||||
No | |||||
Yes | 1.010 | <0.005 | 2.747 | 2.638 | 2.859 |
Mitotic Rate f | |||||
2 or less | |||||
3 to 10 | 0.885 | <0.005 | 2.422 | 2.305 | 2.546 |
11 or more | 1.222 | <0.005 | 3.394 | 3.170 | 3.634 |
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Walz, S.N.; Martineau, J.; Scampa, M.; Kalbermatten, D.F.; Oranges, C.M. Melanoma of the Upper Limb and Shoulder: A Surveillance, Epidemiology, and End Results Analysis of Epidemiology and Survival 2000–2019. Cancers 2022, 14, 5672. https://doi.org/10.3390/cancers14225672
Walz SN, Martineau J, Scampa M, Kalbermatten DF, Oranges CM. Melanoma of the Upper Limb and Shoulder: A Surveillance, Epidemiology, and End Results Analysis of Epidemiology and Survival 2000–2019. Cancers. 2022; 14(22):5672. https://doi.org/10.3390/cancers14225672
Chicago/Turabian StyleWalz, Solange N., Jérôme Martineau, Matteo Scampa, Daniel F. Kalbermatten, and Carlo M. Oranges. 2022. "Melanoma of the Upper Limb and Shoulder: A Surveillance, Epidemiology, and End Results Analysis of Epidemiology and Survival 2000–2019" Cancers 14, no. 22: 5672. https://doi.org/10.3390/cancers14225672