[Cutaneous melanomas in old patients. Prognostic factors and actuarial survival].
A study of 80 consecutive cutaneous malignant melanomas in 78 patients older than 60 years, with an average of 73 (60-93), is presented. The following data were considered: age, sex, localization, stage, other synchronous or metachronous malignant tumors, excluded basal cell epitheliomas, histological type and depth of cutaneous invasion according to Clark's levels and Breslow's measure. The follow up lasted 1 to 156 months with an average of 39 months. All patients were treated by surgical removal of the cutaneous lesion or the regional lymph node metastases, if they appeared. No prophylactic lymph node dissections were performed. There were 45 women and 33 men. The histological type was superficial spreading (ES) in 17 women and 7 men; nodular (NOD) in 18 and 16; lentigo maligna melanoma (LM) in 4 and 4 and acral in 7 and 7. Relations between sex, localization, histological type and actuarial survival curves can be observed in Figs. 5, 6, 7, 8 and Tables 1, 2. Even considering the shortcomings of this retrospective analysis and a relatively short follow up for melanomas, this study points out that the thickness of the lesion became prognostically significant in relation to survival, beyond 3.7 mm (p < 0.001); but when the tumors were thinner, this group of patients showed other causes of death (MPOC) with a greater frequency than those related to tumoral progression (MPM) (p < 0.001) and that maybe this should be taken into account when planning treatment for melanomas in elderly patients. Other malignant synchronous or metachronous tumors were found in 19% of the patients (Table 2).