Epidemiology of cutaneous melanoma in Sweden-Stage-specific survival and rate of recurrence

Int J Cancer. 2016 Dec 15;139(12):2722-2729. doi: 10.1002/ijc.30407. Epub 2016 Sep 22.

Abstract

Cutaneous malignant melanoma (CMM) incidence is increasing globally, making a thorough understanding of the disease and its outcomes essential for optimizing care even more urgent. In this population-based, retrospective study, we investigated stage-specific survival and recurrence/progression rates of CMM among patients diagnosed in Stockholm County Council during 2005-2012, before the wide introduction of targeted therapy. A total of 3,554 CMM patients from the Stockholm Melanoma Register were included. Information on comorbidities, progression, death, and treatments was obtained from nationwide registers and hospital electronic medical records. Unadjusted 5-year survival varied from 91.4% for stage I to 24.6% for stage IV patients. Stage, age and gender were predictors of survival, with gender an independent predictor of survival for stages IA and IIA. 74.6% of patients remained recurrence/progression-free during follow-up, with 5-year recurrence/progression-free survival rates varying from 85.3% to 12.9% among stages I and IV patients, respectively. In addition to stage, male gender, and age, circulatory system comorbidities increased the risk for recurrence/progression. No statistically significant differences in progression rate for operated and non-operated patients could be detected, possibly due to high rate (98.9%) of surgery. Our estimates of survival and recurrence rates are consistent with historical and global expectations and can serve as a baseline to gauge population-level improvements with use of novel melanoma treatments.

Keywords: melanoma; progression; recurrence; stage at diagnosis; survival.

MeSH terms

  • Adult
  • Aged
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Melanoma / epidemiology
  • Melanoma / mortality*
  • Melanoma / pathology*
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Population Surveillance
  • Prognosis
  • Proportional Hazards Models
  • Registries
  • Retrospective Studies
  • Skin Neoplasms
  • Survival Rate
  • Sweden / epidemiology