A ten-year analysis of demographic trends for cutaneous melanoma: Analysisof 2501 cases treated at the University Department of Dermatology in Vienna (1990-1999)

Background: The aim of the study is to provide recent demographic data on c utaneous melanoma in Austria. Patients and methods: Patients with primary cutaneous melanoma diagnosed be tween January 1,1990 and December 31,1999 were included in the analysis. Da ta were retrieved from the melanoma registry of the University Department o f Dermatology in Vienna. Results: In the observation period, 2501 cutaneous melanomas were diagnosed in 2427 patients (mean age: 55.4 yrs; 51.2% females). A total of 267 (10.7 %) cutaneous melanomas were in situ, and 2234 (89.3%) were invasive. The me dian invasion thickness according to Breslow for invasive melanomas was 0.9 8 mm (25%-75% percentiles: 0.55-2.00 mm). We observed a significant trend t owards thicker tumors with increasing age (p < 0.001). In patients less tha n fifty years of age, a significantly higher Breslow thickness was observed in men than in women (0.90 mm versus 0.80 mm, p = 0.03). The median Breslo w thickness of invasive melanoma decreased from 1.20 mm in 1990 to 0.92 mm in 1999 (p for trend, < 0.001). Compared to women, men had melanomas more frequently on the back (43.8% ver sus 24.4%, p < 0.001). In women, melanomas were more frequently found on th e lower legs than in males (21.5% versus 6.7%, p < 0.001). In a multivariat e model, invasion thickness according to Breslow was the single most import ant predictor of survival. Conclusion: Our data confirm recent reports from other European countries w ith regard to the decline in tumor thickness of cutaneous melanoma. Our dat a also demonstrate a need for improving early diagnosis, particularly in ce rtain subgroups of patients.