Tumour stage distribution and survival of malignant melanoma in Germany 2002-2011.

BACKGROUND: Over the past two decades, there has been a rising trend in malignant melanoma incidence worldwide. In 2008, Germany introduced a nationwide skin cancer screening program starting at age 35. The aims of this study were to analyse the distribution of malignant melanoma tumour stages over time, as well as demographic and regional differences in stage distribution and survival of melanoma patients. METHODS: Pooled data from 61 895 malignant melanoma patients diagnosed between 2002 and 2011 and documented in 28 German population-based and hospital-based clinical cancer registries were analysed using descriptive methods, joinpoint regression, logistic regression and relative survival. RESULTS: The number of annually documented cases increased by 53.2% between 2002 (N = 4 779) and 2011 (N = 7 320). There was a statistically significant continuous positive trend in the proportion of stage UICC I cases diagnosed between 2002 and 2011, compared to a negative trend for stage UICC II. No trends were found for stages UICC III and IV respectively. Age (OR 0.97, 95% CI 0.97-0.97), sex (OR 1.18, 95% CI 1.11-1.25), date of diagnosis (OR 1.05, 95% CI 1.04-1.06), 'diagnosis during screening' (OR 3.24, 95% CI 2.50-4.19) and place of residence (OR 1.23, 95% CI 1.16-1.30) had a statistically significant influence on the tumour stage at diagnosis. The overall 5-year relative survival for invasive cases was 83.4% (95% CI 82.8-83.9%). CONCLUSIONS: No distinct changes in the distribution of malignant melanoma tumour stages among those aged 35 and older were seen that could be directly attributed to the introduction of skin cancer screening in 2008.

Expression profiles for 14-3-3 zeta and CCL20 in pancreatic cancer and chronic pancreatitis.

BACKGROUND: Pancreatic cancer (PCA) has a dismal prognosis because it is often diagnosed at an advanced stage. The overall survival rate is <5% after five years. Chronic pancreatitis (CP) is one of the most important risk factors for PCA. A major difficulty is to distinguish between CP and PCA at both clinical and morphologic level. The aim of this study was to assess the impact of the expression profiles for 14-3-3 zeta and CCL20 to histologically discriminate between PCA and CP. METHODS: In PCA (n=138) and CP (n=36) tissue samples, the expression of 14-3-3 zeta and CCL20 was examined by immunohistochemistry. Associations between expression profiles of 14-3-3 zeta and CCL20 expression in PCA, CP as well as MANT (matched adjacent normal tissue) (n=138) and clinicopathologic variables were analyzed. RESULTS: The expression of CCL20 and 14-3-3 zeta was significantly higher in PCA than in CP and MANT. For CP compared to MANT, no significant differences were observed for expression profiles of both 14-3-3 zeta and CCL20. CONCLUSION: CCL20 and 14-3-3 zeta are molecules that play a putative role during tumorgenesis in pancreas, and may therefore be new parameters for histological diagnosis and discrimination between PCA and CP.

Splenic metastases--not a frequent problem, but an underestimate location of metastases: epidemiology and course.

OBJECTIVE: In the literature the frequency of splenic metastasis is documented very inconsistently. Only metastases of ovarial cancer are recommended for a surgical therapy. We examined the frequency of splenic metastasis in our hospital. METHOD: The data of the Tumorboard Schwerin has been analyzed for splenic metastases. Based on hospital documents and contact via telephone the clinical course of the patients was also examined. RESULTS: A total of 6,137 of 29,364 patients with malignant tumors developed metastases (20.9%). We found 59 of these patients with splenic metastases (0.96%; 0.002% of all patients with malignant tumors). Men were more frequently concerned then women. The median age of the patients was 62 (26-88) years. There are only a few primary tumors metastasized in more than 1% into the spleen. A total of 47% of these metastases were synchronous, 53% metachronous. Only three patients had isolated splenic metastasis. Two further patients also had lymph node metastasis in the splenic hilus. Two other patients developed liver metastases after splenectomy. We performed four splenectomies because of splenic metastasis. The survival of splenic metastasis was median 3 (0-61) months. DISCUSSION: The published studies of the frequency of the splenic metastasis are autopsy studies, which are not usable for epidemiological statements because of selection bias. We show that splenic metastases arise in less than 1% of all metastases. A splenectomy in case of splenic metastases makes sense, if the metastases are isolated. It is also meaningful as a debulking procedure that would be followed by a chemotherapy, e.g. in case of an ovarial carcinoma. As a result the survival is increased for patients undergoing splenectomy (median survival 19.5 vs. 3 months).