In a recent study titled “Prognostic differences across sexes in melanoma patients: what has changed from the past?”, published in Melanoma Research, a research team from the University of Turin has designed a single-institution hospital-based cohort study to evaluate the different trends across time in male versus female melanoma patients.
The authors investigated melanoma clinicopathologic features based on different genders and their alterations after the introduction of sentinel lymph node biopsy (SLNB).
Furthermore, this study aimed to determine the metastatic pathways between sexes and the prognostic role of sex in the disease-free interval (DFI), disease-specific survival (DSS) and survival after recurrence.
The rate of cutaneous melanoma (CM) varies across geographical regions and genders. For example, in Europe, this rate is higher in women than in men, however, in the USA and Australia, men are actually more affected than women.
It is known that male melanoma patients have a worse outcome than women, as they are commonly diagnosed at an older age and have predominant axial melanoma localization, while women usually have melanomas localized in the legs. Important, sex has also been determined as an independent prognostic factor.
The research team evaluated the clinical records of 4310 stage I–II melanoma patients, who had been diagnosed, treated and followed-up in their institution from 1975 until 2011. The team divided patients into two distinct groups: before and after the introduction of sentinel lymph node biopsy (in 1999).
The results showed that until 1999 there was a female prevalence within melanoma patients, however, between 1999 and 2003, there was an increasing male trend. After 1999, male patients had an increased improvement in terms of DFI and DSS. However, after the introduction of sentinel lymph node biopsy, sex had a lower influence on DFI and survival.
In patients who had melanoma located in the trunk, sex played no role in the rate of DSS, however, in patients who had primary lesions located in other areas of the body, sex was still a significant prognostic element in both groups under study.
“Sex is associated with a different distribution of clinical features and could play a role as a prognostic indicator”, the authors write in their study. “These data suggest that the recent changes in surgical/therapeutic intervention, such as SLNB, could have a different impact across the sexes”, they conclude.
