Melanoma in Buckinghamshire: Data from the Inception of the Skin Cancer Multidisciplinary Team

Background. Melanoma incidence is increasing faster than any other cancer in the UK. The introduction of specialist skin cancer multidisciplinary teams intends to improve the provision of care to patients suffering from melanoma. This study aims to investigate the management and survival of patients diagnosed with melanoma around the time of inception of the regional skin cancer multidisciplinary team both to benchmark the service against published data and to enable future analysis of the impact of the specialisation of skin cancer care. Methods. All patients diagnosed with primary cutaneous melanoma between January 1, 2003 and December 3, 2005 were identified. Data on clinical and histopathological features, surgical procedures, complications, disease recurrence and 5-year survival were collected and analysed. Results. Two hundred and fourteen patients were included, 134 female and 80 males. Median Breslow thickness was 0.74？mm (0.7？mm female and 0.8？mm male). Overall 5-year survival was 88% (90% female and 85% male). Discussion. Melanoma incidence in Buckinghamshire is in keeping with published data. Basic demographics details concur with classic melanoma distribution and more recent trends, with increased percentage of superficial spreading and thin melanomas, leading to improved survival are reflected. 1. Introduction Melanoma is currently the 6th commonest cancer in the United Kingdom with more than 12,000 new cases diagnosed each year [1]. The incidence of melanoma is increasing faster than any other cancer in the UK with rises of 62% in males and 49% in females in the last decade. Despite this, the rise in mortality has been more modest with increases of 14% in males and 12% in females, and therefore overall survival rates have improved. This disparity between increased incidence and mortality and improved survival is due to the noncongruent increase in the different histological subtypes: superficial spreading, in situ, and thin melanoma incidence has increased significantly more than nodular and thicker melanomas [2, 3]. The prognosis of superficial spreading melanoma is considerably better than nodular melanoma, and therefore survival rates are improving with 80% of men and 90% of women now surviving 5 years [1]. The importance of melanoma thickness and depth of invasion for melanoma survival was noted by Clark in 1967 and Breslow in 1970 when they devised their respective staging systems [4]. The thickness of melanoma is still a crucial predictor of melanoma survival and current staging systems, for example, the American Joint Committee on