Elderly Age Is Associated With More Conservative Treatment of Invasive Melanoma.
Sentinel lymph node biopsy (SLNB)
chemotherapy
immunotherapy
lymphadenectomy
radiation
Journal
Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
30
03
2020
revised:
14
04
2020
accepted:
15
04
2020
entrez:
6
5
2020
pubmed:
6
5
2020
medline:
4
6
2020
Statut:
ppublish
Résumé
Competing mortality risks complicate treatment of elderly melanoma patients potentially leading to conservative management, including no sentinel lymph node biopsy. As systemic immunotherapy offers justification for nodal evaluation, we examined treatment trends among elderly melanoma patients. We performed a National Cancer Database analysis of melanoma patients from 2004-2015. Patients were categorized by age (elderly ≥80-years-old). Multivariable logistic regression analyses were performed comparing characteristics and treatment by age. Of 187,814 patients, 2.7% were 1-25, 11.6% were 26-40, 46.6% were 41-64, 28.8% were 65-79, and 10.3% were ≥80-years-old with clinicopathologic and treatment differences between age cohorts. Nodal surgery was least common among elderly patients (43.1% vs. 60.7-69.8%, p<0.0001). For stage III, immunotherapy was least common among the elderly (p<0.0001), but associated with greater survival (HR=0.52, 95%CI=0.32-0.84, p=0.008). Elderly melanoma patients were often treated conservatively, including no nodal evaluation, concerning for the potential undertreatment of this population.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Competing mortality risks complicate treatment of elderly melanoma patients potentially leading to conservative management, including no sentinel lymph node biopsy. As systemic immunotherapy offers justification for nodal evaluation, we examined treatment trends among elderly melanoma patients.
PATIENTS AND METHODS
METHODS
We performed a National Cancer Database analysis of melanoma patients from 2004-2015. Patients were categorized by age (elderly ≥80-years-old). Multivariable logistic regression analyses were performed comparing characteristics and treatment by age.
RESULTS
RESULTS
Of 187,814 patients, 2.7% were 1-25, 11.6% were 26-40, 46.6% were 41-64, 28.8% were 65-79, and 10.3% were ≥80-years-old with clinicopathologic and treatment differences between age cohorts. Nodal surgery was least common among elderly patients (43.1% vs. 60.7-69.8%, p<0.0001). For stage III, immunotherapy was least common among the elderly (p<0.0001), but associated with greater survival (HR=0.52, 95%CI=0.32-0.84, p=0.008).
CONCLUSION
CONCLUSIONS
Elderly melanoma patients were often treated conservatively, including no nodal evaluation, concerning for the potential undertreatment of this population.
Identifiants
pubmed: 32366440
pii: 40/5/2895
doi: 10.21873/anticanres.14266
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2895-2903Informations de copyright
Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.