Of recent concern, however, is the rising melanoma incidence in white women younger than 40 years; annual incidence of melanoma more than doubled in this group from 1980-2004.
Increased UV radiation exposure through tanning bed use, a World Health Organization (WHO)–classified carcinogen, has been proposed as a potential explanation for this alarming trend.
Prior to the advent of checkpoint inhibitors and targeted therapy for melanoma, prognosis for distant metastatic disease was extremely poor, with median survival of only 6-9 months and 5-year survival rates of less than 20%, depending on the site(s) of metastasis.
In general, patients with soft tissue, nodal, and isolated lung metastases have had slightly better prognoses than those with other visceral metastases and/or elevated LDH levels.
Melanoma incidence has continued to increase worldwide, with the highest incidence in Australia and New Zealand.Regional lymph node metastasis is associated with a 5-year survival rate of 38-78%, depending on the number of nodes involved, microscopic or macroscopic (matted nodes/gross extracapsular extension) disease, and ulceration of the primary melanoma.In-transit metastasis/satellite lesions are associated with a 69% 5-year survival rate, with a significantly worse prognosis in the setting of concomitant regional nodal metastasis (40%).Despite remarkable advances in the treatment of metastatic disease, detection and treatment of cutaneous melanoma in its thin, early phase remains the best chance for cure.Intermediate-thickness melanoma (1.01-4 mm) is associated with a 5-year survival rate of 68-91%, depending on ulceration, thickness (1.01-2 mm, 2.01-4 mm) of the primary tumor, and sentinel lymph node biopsy status.