Natural history of invasive cutaneous melanoma in Styria, Austria 2001-2003.

BACKGROUND: Rising melanoma incidences have created the need of assessment of epidemiological and clinical data. PATIENTS AND METHODS: We investigated the natural history of invasive cutaneous melanoma in Styria, a province of Austria, in the years 2001-2003. 1082 patients, 511 men and 571 women, mean age 58.2 +/- 16.7 years, were collected. Besides basic melanoma data, special histologic features such as regression structures, ulceration, microsatellites and vascular invasion were investigated. Furthermore, lymph node pathology in case of sentinel node biopsy and/or lymph node dissection was recorded. RESULTS: Mean annual incidence (crude rate) was 28.6 per 100,000 inhabitants, age standardized rate 24.5 per 100,000 (95 % CI 22.4-26.6). Cumulative risk (0- 74 years) was 1.92, lifetime risk 1 in 52. Superficial spreading melanoma was the most common type in both sexes, men on the trunk and women on the extremities. Only 11 % of all melanomas were in easily visible areas. Median tumor thickness was 0.75 mm, ranging between 0.2 and 50.0 mm. Sentinel node biopsy was performed in 158 melanomas (14.6 %),and was positive in 22 %.Primary therapeutic lymph node dissection was performed in 19 patients, showing metastases in 18 patients. CONCLUSIONS: The investigation revealed an unclear high melanoma incidence for invasive melanomas in our province, requiring further investigation.