Does the morphology of cutaneous melanoma help explain the international differences in survival? Results from 1,578,482 adults diagnosed during 2000-2014 in 59 countries (CONCORD-3)

Source: Urban Health Today, March 2022

This article was originally published here

Br J Dermatol. 2022 Mar 29. doi: 10.1111/bjd.21274. Online ahead of print.


BACKGROUND: CONCORD-3 highlighted wide disparities in population-based 5-year net survival during 2000-2014. Clinical evidence suggests marked international differences in the proportion of lethal acral and nodular subtypes.

OBJECTIVES: We aim to assess whether the differences in morphology may explain global variation in survival.

METHODS: We grouped melanoma into seven morphology categories: malignant melanoma, not otherwise specified (ICD-O-3 morphology code 8720), superficial spreading melanoma (8743), lentigo maligna melanoma (8742), nodular melanoma (8721), acral lentiginous melanoma (8744), desmoplastic melanoma (8745) and other morphologies (8722-8723, 8726-8727, 8730, 8740-8741, 8746, 8761, 8770-8774, 8780). We estimated net survival with the non-parametric Pohar-Perme estimator, correcting for background mortality by single year of age, sex and calendar year in each country or region. All-ages survival estimates were standardised with the International Cancer Survival Standard weights. We fitted a flexible parametric model to estimate the effect of morphology on the hazard of death.