Time trends in malignant melanoma of the upper limb in Connecticut

Article Abstract:

Malignant melanoma is an especially aggressive form of skin cancer which often arises in nevi (moles). The incidence of this cancer has been increasing for several decades among white people around the world. This increase is thought to result from changes in habits and leisure time which have led to increased exposure to sunlight. To document the change in any cancer over time requires records that have been carefully kept for many years. Such records are generally available only in Scandinavian countries, where participation in national health care plans has been virtually universal for decades. In the United States, the Connecticut Tumor Registry is the only comparable resource. This Registry is the oldest population-based cancer registry in the world and began in 1935 to register all cases of cancer in that state. Data from this registry was used to tabulate the incidence of melanoma on various parts of the arm and hands. The rationale for this choice of anatomical locations is simple. Exposure of the hands to sunlight is, for the most part, indicative of time spent in the sun but not of changes in fashion, since only the face is left uncovered more often than the hands. Conversely, the exposure of the upper arm to sunlight depends not only upon the time in the sun, but the clothes being worn as well. Over the period from 1935 to 1984, the incidence of melanoma on the hands of men remained essentially constant. The rate of melanoma on the upper arm increased 15 times during this same period. Among women, the rate of melanoma on the hand increased 3 times, while melanoma on the upper arm increased between 12 and 14 times. Curiously, no difference in the rate of melanoma was found between the forearm and the upper arm, despite the fact that the exposure of the forearm to sunlight is intermediate between the hand and the upper arm. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Connecticut, Skin cancer

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Malignant melanoma of soft parts (clear cell sarcoma): a study of 17 cases, with emphasis on prognostic factors

Article Abstract:

Malignant melanoma of soft parts was originally referred to as clear cell sarcoma, but has been recognized as soft tissue cancer composed of melanocytes. In a review of 17 cases, the foot and the knee were found to be the most common locations. The size of the tumor had a significant effect on both the likelihood of metastases (spreading of the cancer) and survival. The proportion of epithelioid cells, which is a negative prognostic indicator in cutaneous malignant melanoma, was not a prognostic factor among these 17 patients. Factors such as sex, race, tumor location, and mitotic rate had no observable effect on outcome. Ten patients died of the tumor; the primary cause of death was metastatic disease. The lungs were the primary target of metastases, and in this way the malignant melanoma of soft parts resembles a soft tissue sarcoma more than cutaneous melanoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Sarcoma

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