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Age as key factor for pattern, timing and extent of distant metastasis in patients with cutaneous melanoma. A study of the German Central Malignant Melanoma Registry.

BACKGROUND: Melanoma incidence rates rise as people age but the impact of aging on distant metastasis is unclear.

OBJECTIVE: To investigate how timing, pattern and extent of distant metastasis is influenced by age.

METHODS: Analysis of a single-center cohort of 1.457 patients of the German Central Malignant Melanoma Registry with prospectively documented follow-up. Findings were compared with those of 1.682 patients from five different institutions. All patients presented initially with stage IA - IIC and developed distant metastasis in their further course.

RESULTS: The number of metastatic sites decreased with increasing age at melanoma diagnosis (p < 0.001). The rate of stage M1d decreased from 50.2% in patients ≤ 50 years to 30.1% in patients > 70 years and the rate of stage M1b increased from 5.8% to 21.5%. The rate of lung metastases remained stable in all investigated age groups (p = 0.54). Distant metastases occurred earlier and more synchronized in patients > 70 years compared with patients ≤ 50 years. The age-dependent decrease of metastatic sites and stable rate of lung metastasis were confirmed by the multi-institutional cohort.

LIMITATIONS: The study was not population-based.

CONCLUSION: Pattern, timing and extent of distant metastasis changes as people age. These findings may be considered when treating melanoma patients of different age.

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