Age-related variations in the treatment of melanoma were observed in a study of melanoma and its management in the elderly compared to younger patients, according to a study by Dragos Ciocan, M.D., of the Unité d’Aide Méthodologique, Hôpital Robert Debré, Reims, France, and colleagues.
Elderly people have the highest incidence of melanoma and life expectancy is increasing in most developed countries, according to the study background.
The study included 1,621 patients with stage I or stage II melanoma in 2004 and 2008. Questionnaires to physicians, a survey of cancer registries and pathology laboratories were used to obtain data for the study that was conducted in five regions in northeastern France.
Older patients had more frequent melanomas involving the head and neck (29.4 percent vs. 8.7 percent); thicker and more frequently ulcerated tumors; and diagnosis of the melanoma occurred more frequently in a general practice setting and less frequently in direct consultation with a dermatologist or regular screening for skin cancer. Time to definitive excision also was longer in older patients, and 16.8 percent of them, compared with 5 percent of the younger population, had insufficient margins. Adjuvant (auxiliary) therapy also was started less frequently in older patients and was prematurely stopped in a higher proportion of that population, according to the study results.
“Age-related variations are observed at every step of melanoma management. The most important concerns are access of elderly people to settings for early diagnosis and excision with appropriate margins,” the authors conclude.
JAMA Dermatol. Published August 14, 2013. doi:10.1001/jamadermatol.2013.706.