Southwestern Surgical Congress Presentation Prognostic factors in young women with cutaneous melanoma Alison L. Burton, B.S. a , Michael E. Egger, M.D. a , Amy R. Quillo, M.D. a , Arnold J. Stromberg, Ph.D. b , Lee Hagendoorn, M.B.A. c , Charles R. Scoggins, M.D., M.B.A. a , Robert C. G. Martin, II, M.D., Ph.D. a , Kelly M. McMasters, M.D., Ph.D. a, *, Glenda G. Callender, M.D. d a Department of Surgery, University of Louisville, 550 S Jackson Street, Ambulatory Care Building, 2nd Floor, Louisville, KY 40202, USA; b Department of Statistics, University of Kentucky, Lexington, KY, USA; c Advertek, Inc, Louisville, KY, USA; d Department of Surgery, Yale University School of Medicine, New Haven, CT, USA KEYWORDS: Melanoma; Age; Women; Gender Abstract BACKGROUND: Gender is an established prognostic factor in cutaneous melanoma; women as a group have a better overall prognosis than men. However, the investigators hypothesized that melanoma in young women may have distinct clinicopathologic features and biologic behavior compared with melanoma in older women, possibly related to tanning bed use and excessive acute episodes of sun ex- posure. METHODS: A retrospective analysis was performed of a large multicenter study that accrued patients between 1996 and 2003 and included patients aged 18 to 70 years with cutaneous mela- noma R1 mm Breslow thickness and no evidence of regional or distant metastatic disease. All women with follow-up data were included. Univariate and multivariate analyses as well as Kaplan-Meier (KM) analysis were performed to test for differences in clinicopathologic variables, disease-free survival (DFS), and overall survival (OS) between female patients %40 and .40 years of age. RESULTS: A total of 1,056 female patients were divided into 2 groups: those .40 years of age (n 5 757 [71.7%]) and those %40 years of age (n 5 299 [28.3%]). Overall, there were no dif- ferences in Breslow thickness, ulceration, or sentinel lymph node status between groups. Compared with older women, younger women were more likely to have truncal melanomas (39.5% vs 29.5%, P 5 .0017) and less likely to have regression of the primary tumor (6.4% vs 11.5%, P 5 .0208). The mean number of sentinel lymph nodes removed was 2.82 for younger women and 2.29 for older women (P , .0001). Multivariate analysis revealed that Breslow thickness, ulceration, and tumor-positive sentinel lymph node were associated with worse DFS in both the younger and older groups; truncal location was associated with worse DFS in the younger group only. The same fac- tors were predictive of OS in both groups, except that ulceration was not significant in the younger This study was presented at the annual meeting of the Southwestern Surgical Congress, Santa Barbara, California, March 2013. The Sunbelt Melanoma Trial is an investigator-initiated clinical trial supported by a grant from Schering Oncology Biotech. The author declares no conflicts of interest. * Corresponding author. Tel.: 11-502-852-5447; fax: 11-502-852-8915. E-mail address: mcmasters@louisville.edu Manuscript received March 21, 2013; revised manuscript September 30, 2013 0002-9610/$ - see front matter Ó 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.amjsurg.2013.10.002 The American Journal of Surgery (2014) 207, 102-108