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Scoggins et al, May 2006, Gender-related differences in outcome for melanoma patients

Reference

Scoggins, C. R., Ross, M. I., Reintgen, D. S., Noyes, R. D., Goydos, J. S., Beitsch, P. D., Urist, M. M., Ariyan, S., Sussman, J. J., Edwards, M. J., Chagpar, A. B., Martin, R.C.G., Stromberg, A. J., Hagendoorn, L., & McMasters, K. M.  Gender-related differences in outcome for melanoma patients. Annals of Surgery, 243(5): 693-700. (2006).

Abstract

Objective: To better understand the factors associated with the well-established gender difference in survival for patients with melanoma. Summary Background Data: Gender is ail important factor in patients with cutaneous melanoma. Male patients have a worse outcome when compared with females. The reasons for this difference are poorly understood. Methods: This prospective multi-institutional study included patients aged 18 to 70 years with melanomas >= 1.0 mm Breslow thickness. Wide excision and sentinel lymph node (SLN) biopsy was performed in all patients. Clinicopathologic factors, including gender, were assessed and correlated with disease-free survival (DFS), distant disease-free Survival (DDFS), and overall survival (OS). Results: A total of 3324 patients were included in the covariate analyses; 1829 patients had follow-up data available and were included in the survival analyses. Median follow-up was 30 months. On univariate analysis, men (n = 1906) were more likely than women to be older than 60 years (P < 0.0001), have thicker melanomas (P < 0.0001), have primary turner regression (P = 0.0054), ulceration (P < 0.0001), and axial primary tumor location (P < 0.0001). On multivariate analysis, age (P = 0.0002), thickness (P < 0.0001), ulceration (P = 0.015), and location (P < 0.0001) remained significant in the model. There was no difference in the rate of SLN metastasis between men and women (P = 0.37) on multivariate analysis. When factors affecting survival were considered, the prognosis was worse for men as validated by lower DFS (P = 0.0005), DDFS (P < 0.0001), and OS (P < 0.0001). Conclusions: Male gender is associated with a greater incidence of unfavorable primary tumor characteristics without an increased risk for nodal metastasis. Nonetheless, gender is an independent factor affecting survival
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