Annals of Oncology Advance Access originally published online on October 31, 2007
Annals of Oncology 2008 19(3):583-589; doi:10.1093/annonc/mdm498
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melanoma |
Superior survival of females among 10 538 Dutch melanoma patients is independent of Breslow thickness, histologic type and tumor site
1 Department of Public Health, Erasmus MC, Rotterdam
2 Comprehensive Cancer Centre South, Eindhoven
3 Department of Dermatology, Erasmus MC, Rotterdam
4 Department of Dermatology, Amphia Hospital, Breda
5 Comprehensive Cancer Center Amsterdam, Amsterdam
6 Comprehensive Cancer Centre North, Groningen, The Netherlands
* Correspondence to: Dr E. de Vries, Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Tel: +31-10-408-77-30; Fax: +31-10-463-84-75; E-mail: e.devries{at}erasmusmc.nl
Background: Worldwide, female melanoma patients have superior survival compared with males, which is usually ascribed to earlier detection among women and/or a more favorable site distribution. We studied gender difference in melanoma survival in a large population-based setting after adjusting for tumor-related variables and offer clues for further research.
Patients and methods: A total of 10 538 patients diagnosed with melanoma from 1993 to 2004 in The Netherlands were included. Multivariate analyses were carried out to estimate adjusted relative excess risk (RER) of dying for men compared with women, adjusted for the patient and tumor characteristics.
Results: Univariate relative survival analyses showed a RER of dying of 2.70 [95% confidence interval (CI) 2.38–3.06] for men compared with women. After adjusting for time period of diagnosis, region, age, Breslow thickness, histologic subtype, body site, nodal and metastatic status, a significant excess mortality risk was still present for males (RER 1.87, 95% CI 1.65–2.10). Among patients with advanced disease and in those <45 or 
60, the adjusted risk estimates were similar.
Conclusions: The superior survival of women compared with men persisted after adjusting for multiple confounding variables indicating that factors other than stage at diagnosis and body site reduce mortality risk in female melanoma patients.
Key words: gender difference, melanoma, prognosis, relative survival
Received for publication August 8, 2007. Revision received September 24, 2007. Accepted for publication September 25, 2007.
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