Munich Cancer Registry Incidence and Mortality Selection Matrix Homepage Deutsch ICD-10 C43: Malignant melanoma Survival Year of diagnosis 1988-1997 1998-2018 Patients 3,167 19,101 Diseases 3,232 20,050 Cases evaluated 2,932 15,134 Creation date 01/10/2020 Export date 12/31/2019 Population 4.86 m Munich Cancer Registry Cancer Registry Bavaria - Upper Bavaria Regional Center at Klinikum Grosshadern/IBE Marchioninistr. 15 Munich, 81377 Germany https://www.tumorregister-muenchen.de/en https://www.tumorregister-muenchen.de/en/facts/surv/sC43__E-ICD-10-C43-Malignant-melanoma- survival.pdf BERLIN GERMANY MUNICH BAVARIA
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Munich Cancer Registry - tumorregister-muenchen.de€¦ · 2016, and are represented by colored diamonds in order to facilitate comparisons between MCR and SEER. The presented survival
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Munich Cancer Registry
�Incidence and Mortality �Selection Matrix �Homepage �Deutsch
ICD-10 C43: Malignant melanoma
Survival
Year of diagnosis 1988-1997 1998-2018
Patients 3,167 19,101
Diseases 3,232 20,050
Cases evaluated 2,932 15,134
Creation date 01/10/2020
Export date 12/31/2019
Population 4.86 m
Munich Cancer Registry Cancer Registry Bavaria - Upper Bavaria Regional Center at Klinikum Grosshadern/IBE Marchioninistr. 15 Munich, 81377 Germany https://www.tumorregister-muenchen.de/en
Figure 1a. Relative survival of patients with malignant melanoma by period of diagnosis. Included in the evaluation are 17,399 cases diagnosed between 1988 and 2017.
The survival results of the SEER program (Surveillance, Epidemiology, and End Results) of the American National Cancer Institute (NCI) are summarized as the period of diagnosis from 2000 to 2016, and are represented by colored diamonds in order to facilitate comparisons between MCR and SEER.
The presented survival curves are derived from clinical records with valid follow-up informations, which means that death certificate cases (DCO) cases are omitted from the analysis. With this one restriction, the MCR has provided population-based statistics since 1998, collecting data on all cancer cases in the region of southern Bavaria. Historical data of previous time periods can be heavily selected, therefore, univariate survival comparisons of the presented time periods must be carefully considered. Nonetheless, all calculable survival curves are depicted to facilitate the comparison of long time follow-up analyses of relative survival between particular cancers.
Figure 3a. Observed survival of patients with malignant melanoma by age category. Included in the evaluation are 17,399 cases diagnosed between 1988 and 2017.
Figure 3b. Relative survival of patients with malignant melanoma by age category. Included in the evaluation are 17,399 cases diagnosed between 1988 and 2017.
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ICD-10 C43: Malignant melanoma of skinAge category
% N=17,399Observed survival 1988-2017
Age category
0-49 yrsn=5,740 33.0%
50-59 yrsn=3,432 19.7%
60-69 yrsn=3,792 21.8%
70+ yrsn=4,435 25.5%
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ICD-10 C43: Malignant melanoma of skinAge category
% N=17,399Relative survival 1988-2017
Age category
0-49 yrsn=5,740 33.0%
50-59 yrsn=3,432 19.7%
60-69 yrsn=3,792 21.8%
70+ yrsn=4,435 25.5%
GENERAL ICD-10 C43: Malignant melanoma Page 6 of 14
Figure 4a. Relative survival of patients with malignant melanoma by tumor thickness. For 16,548 of 17,399 cases diagnosed between 1988 and 2017 valid data could be obtained for this item. For a total of 14,764 cases an evaluable classification was established. The grey line represents the subgroup of 2,635 patients with missing values regarding tumor thickness (15.1 % of 17,399 patients, the percent values of all other categories are related to n=14,764).
Tumor thickness <=1.0 mm 1.01 - 2 mm 2.01 - 4 mm >4 mm NS n=9,826 n=2,452 n=1,481 n=1,005 n=2,635
Figure 4c. Relative survival of patients with malignant melanoma by tumor thickness. For 13,768 of 14,470 cases diagnosed between 1998 and 2017 valid data could be obtained for this item. For a total of 12,190 cases an evaluable classification was established. The grey line represents the subgroup of 2,280 patients with missing values regarding tumor thickness (15.8 % of 14,470 patients, the percent values of all other categories are related to n=12,190).
Tumor thickness <=1.0 mm 1.01 - 2 mm 2.01 - 4 mm >4 mm NS n=8,142 n=1,964 n=1,222 n=862 n=2,280
Figure 4e. Conditional relative 5-year survival of patients with malignant melanoma by tumor thickness. For 16,548 of 17,399 cases diagnosed between 1988 and 2017 valid data could be obtained for this item. For a total of 14,764 cases an evaluable classification was established. The grey line represents the subgroup of 2,635 patients with missing values regarding tumor thickness (15.1 % of 17,399 patients, the percent values of all other categories are related to n=14,764).
Tumor thickness <=1.0 mm 1.01 - 2 mm 2.01 - 4 mm >4 mm NS
Cond. surv. %
Cond. surv. %
Cond. surv. %
Cond. surv. %
Cond. surv. %
Years n 5 yrs n 5 yrs n 5 yrs n 5 yrs n 5 yrs 0 9,826 101.7 2,452 93.9 1,481 77.6 1,005 52.8 2,635 73.6
Table 4f. Conditional relative 5-year survival of patients with malignant melanoma by tumor thickness for period 1988-2017 (N=14,764).
Conditional relative survival rates refer to the relative survival probability, in this case for 5 years after cancer diagnosis, compared to the age- and sex-matched population (=100 %) under the condition of being alive for a certain time period (x-axis in Figure 4c). The results illustrate to what extent the cancer induced mortality of particular subgroups declines in the subsequent years after detection of the malignancy. For instance, according to the presented survival statistics, patients in the subgroup tumor thickness=“<=1.0 mm”, who are alive at least 3 years after cancer diagnosis, the conditional relative 5-year survival rate is 101.0% (n=7,907).
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Time since diagnosis (years)
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ICD-10 C43: Malignant melanoma of skinTumor thickness
% N=14,764Conditional relative 5 year survival 1988-2017
Tumor thickness
<=1.0 mmn=9,826 66.6%
1.01 - 2 mmn=2,452 16.6%
2.01 - 4 mmn=1,481 10.0%
>4 mmn=1,005 6.8%
NSn=2,635 15.1%
PROGRESSION ICD-10 C43: Malignant melanoma Page 10 of 14
Figure 5a. Time to first progression of 14,215 patients with malignant melanoma diagnosed between 1998 and 2017 (in solid cancers M0 only) estimated by cumulative incidence function (CI, solid line) accounting for death as competing risk and by inverse Kaplan-Meier estimate (1-KM, dashed line). The frequency of events may be underestimated due to underreporting.
Type of progression
Any type (CI) Any type (1-KM) Distant
metastasis (CI)
Distant metast. (1-
KM) Locoreg. relapse (CI) Locoreg. rel. (1-KM) NOS (CI)
Table 5b. Time to first progression of patients with malignant melanoma for period 1998-2017 (N=14,215), also showing the total of progression events (Events) and of deaths as competing risk (compet.).
PROGRESSION ICD-10 C43: Malignant melanoma Page 12 of 14
Figure 5c. Observed post-progression survival of 2,143 patients with malignant melanoma diagnosed between 1998 and 2017. These 2,143 patients with documented progression events during their course of disease represent 15.1 % of the totally 14,215 evaluated cases (incl. M1, n=628, 4.4 %). Patients with cancer relapse documented via death certificates only were excluded (n=241, 1.7 %). Multiple progression types on different sites are included in the evaluation even when not occuring synchronously. The NOS (not otherwise specified) class is included under the condition, that it is the one and only progression type during the course of disease.
Medical record documentation often lacks the linguistic severity to distinguish between local relapse, regional lymph node metastasis and distant spread in solid cancers. Frequently, the statement “not specified” is the only information in registries regarding relapse of the disease. The category “Any type” denotes all cases who suffered from at least one relapse during the course of disease (incl. primary M1-status). Although, the real number of relapsed patients is likely to be much higher. The accumulated percentage of patients with local relapse or distant metastasis exceeds the 100 % value because patients are potientially considered in more than one subgroup.
Type of progression
Any type Distant metastasis Locoregional relapse NOS n=2,143 n=1,698 n=842 n=142
Years % % % % 0 100.0 100.0 100.0 100.0
1 61.4 50.3 74.1 80.3
2 45.7 33.9 57.9 67.0
3 37.0 26.1 48.4 52.0
4 32.5 22.4 42.3 49.1
5 29.8 20.6 38.5 43.9
6 27.2 18.7 34.5 41.5
7 25.1 16.6 32.1 38.5
8 23.7 15.6 30.5
9 22.3 14.3 29.3
10 21.4 14.1 27.6
Table 5d. Observed post-progression survival of patients with malignant melanoma for period 1998-2017 (N=2,143).
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ICD-10 C43: Malignant melanoma of skinProgression type
Figure 5e. Observed post-progression (distant metastasis) survival of 2,184 patients with malignant melanoma diagnosed between 1988 and 2017 by period of progression.
Period of progression 1988-1997 1998-2006 2007+ n=286 n=662 n=1,236
Years % % % 0 100.0 100.0 100.0
1 51.0 50.5 51.1
2 37.0 35.2 34.5
3 30.5 27.9 26.5
4 26.0 22.6 23.2
5 23.1 20.9 21.2
6 19.7 19.1 18.8
7 18.2 16.8 16.6
8 16.7 16.0 15.2
9 15.6 14.7
10 15.2 14.5
Table 5f. Observed post-progression (distant metastasis) survival of patients with malignant melanoma for period 1988-2017 by period of progression (N=2,184).
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ICD-10 C43: Malignant melanoma of skinType of Progression: Distant metastasis
% N=2,184Observed post-progression survival by period of progression date 1988-2017
Period of progression
1988-1997n=286 13.1%
1998-2006n=662 30.3%
2007+n=1,236 56.6%
USAGE ICD-10 C43: Malignant melanoma Page 14 of 14
SEER Surveillance, Epidemiology, and End Results, USA
UICC Union for International Cancer Control, Geneva
DCO Death certificate only Death certificate provides the only notification to the registry.
NA Not available
NOS Not otherwise specified
OS Overall/Observed survival Overall/Observed survival (Kaplan-Meier estimate) Date of entry: diagnosis Event: death from any cause
RS Relative survival Survival compared to “general population”, ratio of observed to expected survival (Ederer II method), reflecting cancer specific survival
AS Assembled survival Assembled chart of observed, expected, relative survival
CS Conditional survival Survival probability under the condition of surviving a given period of time
TTP Time to progression Time to first progression / relapse Date of entry: diagnosis Event: (progression / relapse): first local-, lymph node recurrence, distant metastasis or unspecified progression
1-KM 1 minus Kaplan-Meier estimator (“inverse” Kaplan-Meier estimator)
CI Cumulative incidence Death as competing risk (according to Kalbfleisch und Prentice)
PPS Post-progression survival Survival since first progression / relapse (Kaplan-Meier estimate) Date of entry (progression / relapse): first local-, lymph node recurrence, distant metastasis or unspecified progression Event: death from any cause
Recommended Citation
Munich Cancer Registry. Survival ICD-10 C43: Malignant melanoma [Internet]. 2020 [updated 2020 Jan 10; cited 2020 Mar 1]. Available from: https://www.tumorregister-muenchen.de/en/facts/surv/sC43__E-ICD-10-C43-Malignant-melanoma-survival.pdf
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