Age as key factor for pattern, timing and extent of distant metastasis in patients with cutaneous melanoma. A study of the German Central Malignant Melanoma Registry

Publication date: Available online 29 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Maximilian Gassenmaier, Ulrike Keim, Ulrike Leiter, Thomas K. Eigentler, Martin Röcken, Anja Gesierich, Rose K.C. Moritz, Lucie Heinzerling, Thomas Tüting, Uwe Wollina, Claus Garbe

Abstract

Background

Melanoma incidence rates rise as people age but the impact of aging on distant metastasis is unclear.

Objective

To investigate how timing, pattern and extent of distant metastasis is influenced by age.

Methods

Analysis of a single-center cohort of 1.457 patients of the German Central Malignant Melanoma Registry with prospectively documented follow-up. Findings were compared with those of 1.682 patients from five different institutions. All patients presented initially with stage IA – IIC and developed distant metastasis in their further course.

Results

The number of metastatic sites decreased with increasing age at melanoma diagnosis (p < 0.001). The rate of stage M1d decreased from 50.2% in patients ≤ 50 years to 30.1% in patients > 70 years and the rate of stage M1b increased from 5.8% to 21.5%. The rate of lung metastases remained stable in all investigated age groups (p = 0.54). Distant metastases occurred earlier and more synchronized in patients > 70 years compared with patients ≤ 50 years. The age-dependent decrease of metastatic sites and stable rate of lung metastasis were confirmed by the multi-institutional cohort.

Limitations

The study was not population-based.

Conclusion

Pattern, timing and extent of distant metastasis changes as people age. These findings may be considered when treating melanoma patients of different age.

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