The mortality of invasive maligant melanoma. A review with special consideration of gender variations

Background and Objective. The final goals of malignant melanoma prevention are lowering incidence and mortality. We assessed the parameter "survival" for both men and women as the beginning point for future gender-directed pr evention campaigns. We compared the periods 1972-1980, 1981-1988, 1989-1996 , and determined the influence of age a nd of Breslow' tu mor thickness on survival. Patients/Methods. We had sufficient follow-up on 10.433 patients. We calcul ated survival curves according to Kaplan-Meier and defined differences by t he logrank test. Results. At all periods of time,survival of women was higher compared with men, but with no impressive changes over time. This was especially true for younger men. The most important prognostic factor was the Breslow tumor th ickness. Within all periods of time, its median was higher in men. A trend downwards for both genders could be observed with higher influence on survi val In men. Conclusions. Our findings justify melanoma prevention campaigns addressed t o men. Evaluation of such campaigns has to take into account an already exi sting upwards trend for male survival, which exceeds that of female surviva l.