Cutaneous Head and Neck Melanoma: Changes in Clinical and Histologic Features From 1995 to 2015 in a Tertiary Hospital in Madrid, Spain

Autor: J.A. Avilés Izquierdo, I. Hernández Aragüés, R. Suárez Fernández
Rok vydání: 2020
Předmět:
Zdroj: Actas Dermo-Sifiliográficas (English Edition). 111:503-509
ISSN: 1578-2190
Popis: Background and objective Few epidemiological studies have analyzed cutaneous head and neck melanoma (CHNM) in the Spanish population. The aim of this study was to describe the clinical and histologic features of a representative sample of CHNM in Spain and to analyze changes observed over a period of 21 years. Material and methods Descriptive, retrospective, cross-sectional study of 280 patients diagnosed with CHNM at Hospital General Universitario Gregorio Maranon in Madrid, Spain, between January 1, 1995, and December 31, 2015. The main clinical and histologic features were analyzed and compared between 3 periods: 1995–2001, 2002–2008, and 2009–2015. Results Mean age at diagnosis was 71.3 years (median, 74 years; interquartile range [IQR], 65–81 years). The most common location was the face, followed by the scalp. The main histologic subtype was lentigo maligna (n = 172, 64%). Mean tumor thickness was 1.6 mm (median, 0.4 mm; IQR, 0–2.1 mm). Median follow-up was 111 months; in this time 51 patients experienced CHNM recurrence (18.2%) and 29 died of the disease (10.4%). In the years analyzed, we observed a significant increase in the number and percentage of patients aged 75 years or older (P = .001) and in the percentage of melanomas in situ (P = .003). We also observed a significant decrease in mean tumor thickness (P = .018), the number of cases with 6 or more mitotic figures (P = .013), the percentage of patients with metastasis (P = .014), and melanoma-specific mortality (P = .005). Conclusions CHNM affects elderly patients and is preferentially located on the face. The predominant subtype is lentigo maligna. Patients presented with thinner tumors over time and are now less likely to develop metastasis and to die of melanoma.
Databáze: OpenAIRE