Τομέας ΠαθολογίαςLibrary of the School of Health Sciences
Γκόγκα Ελένη, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Κωνσταντόπουλος Κωνσταντίνος, Καθηγητής, Ιατρική, ΕΚΠΑ
Σαμάρκος Μιχαήλ, Αναπλ. Καθηγητής, Ιατρική, ΕΚΠΑ
Στρατηγός Αλέξανδρος, Καθηγητής, Ιατρική, ΕΚΠΑ
Βύνιου Αθηνά, Αναπλ. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Ψυχογιού Μήνα, Αναπλ. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Μαντζουράνη Μαρίνα, Αναπλ. Καθηγήτρια, Ιατρική, ΕΚΠΑ
Επιδημιολογική μελέτη μελανώματος σε ασθενείς άνω των 60 ετών στον Ελληνικό πληθυσμό
Αn epidemiological study of melanoma in patients over 60 years of age in the Greek population
Introduction – Aim of the studyDuring the last years, melanoma incidence rose considerably, especially in more advanced age groups. The aim of the present prospective registry study was to describe the epidemiological, clinical, pathological and surgical treatment characteristics of melanoma patients in Greece and to compare patients aged above vs. below 60 years old. MethodsData were prospectively collected from 934 patients who were subjected to surgical resection of newly diagnosed melanoma during the years 1987-2014 in the Department of Plastic Surgery, Microsurgery and Burn Center "J. Ioannovich", Athens General State Hospital "G. Gennimatas". The statistical package SPSS 22.0 was used for all analyzes. ResultsIn total, 491 women and 443 men were included in the study. Four age groups were studied: 237 (25.4%) were 15-39 years old, 360 (38.5%) were 40-59 years old, 181 (19.4%) were 60-69 years old και 156 (16.7%) were 70-93 years old. Comparison of the above groups led to the following results: an increasing incidence of primary tumor location at the head and neck area and a decreasing incidence at the trunk were observed in more advanced ages. Superficial spreading melanoma presented more frequently in younger ages, while nodular melanoma was more frequent in patients who were ≥70 years old. Acral melanoma and lentigo maligna melanoma histological subtypes became more common with advancing age. Thick or ulcerated melanomas or melanomas with histological regression were observed more often in patients aged ≥60 years. Additionally, patients above 60 years old presented more often melanomas with a mitotic rate > 6/mm2 and with neurotropism. Multivariate regression analysis showed that primary tumor location at the head and neck area, lentigo maligna melanoma histology, the presence of ulceration or regression, mitotic rate >6/mm2, and spindle and balloon cell subtypes were independently associated with an age of diagnosis ≥ 60 years, while primary tumor location at the trunk was negatively associated with age ≥ 60 years. Regarding surgical treatment, multivariate regression analysis showed that an age of diagnosis above 70 years was independently associated with a lower chance of having sentinel lymph node biopsy or regional lymph node resection, while the incidence of regional lymph node infiltration by melanoma did not differ between age groups. ConclusionsThe study confirmed that patients of advanced age present more commonly melanomas with adverse features. It describes prospective data from a large registry of melanoma patients who were diagnosed in Greece and are representative of the Southern European population, where information is scarce. The results of this study might contribute in intensifying the participation of older people to melanoma screening programs, as well as to the improvement of therapeutic management of older melanoma patients.
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Olga Benopoulou-Phd Thesis.pdf
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