{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T13:25:09Z","timestamp":1787405109224,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2007,1,30]],"date-time":"2007-01-30T00:00:00Z","timestamp":1170115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2007,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND.<\/jats:title><jats:p>A hypothesis generated a retrospective analysis of the improvement of survival over time in patients with cutaneous melanoma (CM) in order to identify factors contributing to this progress.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS.<\/jats:title><jats:p>A cohort of 4791 patients diagnosed with primary CM in southern Germany between 1976 and 2001 was analyzed. Kaplan\u2010Meier analyses were performed to estimate and to compare overall survival (OS) and survival after first recurrence (SAR). The Cox proportional hazards model was used to evaluate the effect of multiple variables on OS and SAR.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS.<\/jats:title><jats:p>Diagnosis of primary CM during 1990\u20132001 compared with 1976\u20131989 was associated with more favorable 10\u2010year OS (88.6% vs 80.0%, <jats:italic>P<\/jats:italic> &lt; .0001). The median tumor thickness at primary diagnosis was significantly lower during the second period (0.75 mm vs 1.07 mm, <jats:italic>P<\/jats:italic> &lt; .0001). In the multivariate analysis, adjusted for tumor thickness, ulceration, age, gender, and anatomical site, the period of diagnosis retained its significance as a predictor of OS (<jats:italic>P<\/jats:italic> = .002). The SAR was more favorable during the second period in patients who developed their first metastasis in the regional lymph nodes (45.2% vs 32.9%, <jats:italic>P<\/jats:italic> = .017) or in distant sites (13.4% vs 2.0%, <jats:italic>P<\/jats:italic> = .0002) and this finding persisted in the multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS.<\/jats:title><jats:p>Improvement of survival of CM patients diagnosed 1990\u20132001 as compared with 1976\u20131989 may not be entirely attributable to factors associated with early diagnosis and more favorable primary tumors. Therefore, factors of melanoma management, which changed between the 2 time periods, such as sentinel node biopsy, adjuvant treatment, structured follow\u2010up, and surgical interventions in distant metastasis, may have to be taken into account. Cancer 2007 \u00a9 2007 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.22511","type":"journal-article","created":{"date-parts":[[2007,2,2]],"date-time":"2007-02-02T18:10:51Z","timestamp":1170439851000},"page":"1174-1182","source":"Crossref","is-referenced-by-count":43,"title":["Improvement of overall survival of patients with cutaneous melanoma in Germany, 1976\u20132001"],"prefix":"10.1002","volume":"109","author":[{"given":"Konstantinos G.","family":"Lasithiotakis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Leiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Eigentler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Breuninger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisela","family":"Metzler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedegund","family":"Meier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Garbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,1,30]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ssu.10020"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20816"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.03.075"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22126"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.1203"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06409.x"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.11360"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/93.9.678"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09779-9"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/92.10.811"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.01.091"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20000915)89:6<1269::AID-CNCR11>3.0.CO;2-C"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19981015)83:8<1664::AID-CNCR23>3.0.CO;2-G"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11272"},{"key":"e_1_2_5_16_2","first-page":"101","article-title":"Long\u2010term results of a prospective surgical trial comparing 2 cm vs. 4 cm excision margins for 740 patients with 1\u20134 mm melanomas","volume":"8","author":"Balch CM","year":"2001","journal-title":"Ann Surg Oncol."},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030681"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)08260-3"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-000-0087-9"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197709222971202"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199910000-00001"},{"key":"e_1_2_5_22_2","first-page":"S41","article-title":"The Sunbelt Melanoma Trial","volume":"8","author":"McMasters KM","year":"2001","journal-title":"Ann Surg Oncol."},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1067\/S0190-9622(03)02136-4"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1996.14.1.7"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.12.2444"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.9.2370"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-1103-3"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21760"},{"key":"e_1_2_5_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001622-200203000-00011"},{"key":"e_1_2_5_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-001-0658-4"},{"key":"e_1_2_5_31_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.22.3782"},{"key":"e_1_2_5_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-999-0633-z"},{"key":"e_1_2_5_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970615)79:12<2345::AID-CNCR8>3.0.CO;2-K"},{"key":"e_1_2_5_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20000601)88:11<2534::AID-CNCR15>3.0.CO;2-2"},{"key":"e_1_2_5_35_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.16.3622"},{"key":"e_1_2_5_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dji019"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.22511","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.22511","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T20:20:44Z","timestamp":1760300444000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.22511"}},"subtitle":["Which factors contributed?"],"short-title":[],"issued":{"date-parts":[[2007,1,30]]},"references-count":35,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2007,3,15]]}},"alternative-id":["10.1002\/cncr.22511"],"URL":"https:\/\/doi.org\/10.1002\/cncr.22511","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,1,30]]}}}