Original articleA population-based registry study on relative survival from melanoma in Germany stratified by tumor thickness for each histologic subtype
Section snippets
Database
This population-based study used routinely collected observational data from 12 cancer registries that were provided by the Cancer Survival Working Group of the Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (Network of Epidemiologic Cancer Registries in Germany).14 Cancer registries were selected on the basis of the quality of their data regarding the proportion of death certificate–only (DCO) cases. Methods and quality requirements have been outlined in detail before.14
Results
In total, we included 82,901 melanoma cases with a balanced sex ratio (51.0% women) and a median patient age of 62 years at diagnosis (Table I). Median age at diagnosis ranged between 58 and 64 years in the different regions. The percentage of histologically confirmed cancer diagnosis was greater than 98.7% in all registries and was 99.6% overall. In 2002–2013, the percentage of excluded DCO cases was 2.2%. All together, 16,335 patients (19.7%) had melanoma of stage T0 or with an unknown or
Discussion
This population-based registry study focused on the mediating effect of T stage on differences in RS between the histologic subtypes of melanoma. For all histologic subtypes, we found that patients with thicker tumors had a lower RS. Survival differences by histologic subtype were mediated largely, but not completely, by the T-stage distribution. The remaining differences may have been due either to distinct disease processes25 or to residual confounding. Residual confounding could have
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Conflicts of interest: None disclosed.
The study outline was presented in a poster presentation at the annual conference of the German Society for Epidemiology in Munich, Germany, on September 2, 2016. Recent trends in relative survival of melanoma in Germany stratified by age group, T stage, and histologic subtype were presented at the annual conference of the German Society for Epidemiology in Lübeck, Germany, on September 7, 2017, and at the annual conference of the International Association of Cancer Registries in Utrecht, The Netherlands, on October 17, 2017.