1120P - Time trend influence of socieconomic status on survival, breslow thickness, time from onset of symptoms and surgical resection in stage I-II primary...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Skin cancers
Presenter Mario Mandala
Authors M. Mandala1, G. Imberti2, D. Piazzalunga3, R. Labianca1, G. Lucisano4, B. Merelli1, S. Mosconi1, L. Marchesi2, A. Gianatti5, C. Tondini1
  • 1Oncology And Haematology, Ospedali Riuniti di Bergamo, 24100 - Bergamo/IT
  • 2Dermatology, Ospedali Riuniti Bergamo, Bergamo/IT
  • 3Surgical Oncology, Ospedali Riuniti bergamo, Bergamo/IT
  • 4Epidemiology, Mario Negri Sud, Santa Maria Imbaro/IT
  • 5Pathology, Ospedali Riuniti Bergamo, Bergamo/IT



To investigate the time trend influence of socioeconomic status (SES) on Breslow thickness (BT) and survival in patients (pts) with stage I-II primary cutaneous melanoma (PCM).

Patients and methods

Pathologic and sociodemographic characteristics of prospectively collected, consecutive pts diagnosed with PCM between November 1, 1998, and July 31, 2009 were evaluated. We categorized SES into 3 levels: low (manual employees with primary education level), middle (non-manual employees with middle education level), and high (professionals, executives with tertiary education). We divided the representative years between 2000 and 2009 into three four-year (table 1). In the multilvariate analysis models the following variables were tested: SES, marital status, sex and age.


A total of 1274 available pts were analyzed. Overall a progressive decrease of BT was observed (table 1). In the first four year period gender and age correlated with BT and ulceration [m vs f OR (95%CI): 1.66 (1.10-1.52) and (>60 vs <60 OR (95%CI): 2.08 (1.35-3.20) respectively]. In the second and third four year period only SES correlated with Breslow thickness [low vs high OR (95%CI): 2.32 (1.27-4.26)), middle vs high OR (95%CI): 2.26 (1.28-4.00respectively]. SES correlated with time from onset of symptoms and surgical resection [(low vs high OR (95%CI): 3.10 (1.56-6.15)), middle vs high OR (95%CI): 1.86 (1.05-3.31), respectively]. Finally compared with high SES, the risk of melanoma-related death, adjusted for age and sex, was 7 times higher (hazard ratio, 7.44; 95% CI, 3.27-16.93) in patients with low SES living alone.


Our data for the first time demonstrates that BT and survival decreased over time but not for low SES patients. These pts should be considered the optimal target for future prevention campaign Table 1 Time Trend BT decrease in stage I-II primary cutaneous melanoma.

MEASURE CLASS 2000_2002 2003_2005 2006_2009 PVALUE
N. Group . 417 442 415
breslow_r (median (Q1-Q3) . 0.60 (0.32-1.35) 0.50 (0.30-1.25) 0.45 (0.21-0.92) 0,0002


All authors have declared no conflicts of interest.