SO12P DESMOPLASTIC MELANOMA: A REVIEW OF THE 10 YEAR EXPERIENCE AT PETER MACCALLUM HOSPITAL

Introduction:   Desmoplastic melanoma is an uncommon type of melanoma. There are conflicting opinions and data in the literature regarding its presentation, treatment and prognosis. Methods:   From 1998 to 2008, 22 consecutive patients with desmoplastic melanoma from the Peter MacCallum Hospital were reviewed. There were 7 females; 15 males. The mean age was 77.5. The mean follow-up period was 37 months. Results:   The most common anatomical location was in the head and neck region. The mean Breslow thickness was 6.8 mm. 50% of the melanomas were Clark level 5. 45% showed neutropism and 27% showed amelanosis. The mean excisional margin was 18.2 mm. 4 patients underwent sentinel node biopsy and were all negative. 18% patients received radiotherapy. 27% of patients developed local recurrence; 9% nodal recurrence and 27% distant metastasis. The 5 year survival was 65.7%; the overall survival was 26.3%; and the overall disease-free survival was 45.9%. The presence of neutropism, the surgical margin and radiotherapy did not have a significant effect on survival. Conclusion:   Desmoplastic melanoma displays a different biological behaviour to other types of melanoma. It tends to present at an advanced stage. Local and distant recurrences are more common than nodal recurrence. A larger prospective study is currently underway at Peter MacCallum Hospital examining the variables that influence the prognosis of this type of melanoma.