A population-based registry study on relative survival from melanoma in Germany stratified by tumor thickness for each histological subtype

Publication date: Available online 20 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Alicia Brunssen, Lina Jansen, Nora Eisemann, Annika Waldmann, Janick Weberpals, Klaus Kraywinkel, Andrea Eberle, Bernd Holleczek, Sylke Ruth Zeissig, Hermann Brenner, Alexander Katalinic, GEKID Cancer Survival Working Group

Abstract

Background

Differences in melanoma relative survival (RS) between histologies were discussed to be mainly caused by tumor thickness.

Objective

To investigate RS from melanoma, stratified by tumor thickness for each histological subtype, and identify survival trends.

Methods

Using cancer registry data on melanoma cases (ICD-10: C43.0-C43.9) diagnosed in Germany in 1997-2013, 5- and 10-year age-standardized RS stratified by histology and stratified or standardized by T-stage was estimated using standard and modelled period analyses. We restricted 10-year RS analyses to patients younger than 75 years.

Results

We analyzed 82,901 cases. Overall, 5- and 10-year RS was 91.7% and 90.8%, respectively. Prognosis worsened with increasing T-stage for all histologies but T-stage distribution varied substantially. Survival differences by histology were strongly alleviated after adjustment for T-stage, but remained significant. Overall, 5-year RS increased significantly by 3.8 percentage points between 2002-2005 and 2010-2013. This increase was no longer seen after adjustment for T-stage.

Limitations

Exclusion of cases due to missing information on T-stages, changes in the definition of T-stages, and lack of information on screening and treatment limit our analyses.

Conclusion

Differences in RS between histologies were strongly mediated by tumor thickness. Over time, melanoma RS increased due to changes in T-stage distribution.