Gender Differences in Melanoma Survival: Female Patients Have a Decreased Risk of Metastasis

Female melanoma patients generally exhibit significantly longer survival than male patients. This populationbased cohort study aimed to investigate gender differences in survival and disease progression across all stages of cutaneous melanoma. A total of 11,774 melanoma cases extracted from the Munich Cancer Registry (Germany), diagnosed between 1978 and September 2007, were eligible to enter the study. Hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for tumor and patient characteristics, were estimated for the end points of survival, regional and systemic progression, and survival after progression. A significant female advantage was observed for melanoma-specific survival (adjusted HR 0.62; 95% CI 0.56–0.70). Women were at a lower risk of progression (HR 0.68; 95% CI 0.62–0.75), including a lower risk of lymph node metastasis (HR 0.58; 95% CI 0.51–0.65) and visceral metastases (HR 0.56; 95% CI 0.49–0.65). They retained a significant survival advantage after first progression (HR 0.81; 95% CI 0.71–0.92) and lymph node metastasis (HR 0.80; 95% CI 0.66–0.96), but this became borderline significant (HR 0.88; 95% CI 0.76–1.03) after visceral metastasis. Localized melanomas in women had a lower propensity to metastasize, resulting in a better survival when compared with men, even after first disease progression. These results suggest differences in tumor–host interaction across gender.

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