Major amputation for malignant melanoma: an epidemiological study.

The annual number of amputations in Denmark as a consequence of malignant melanoma on the limbs has been constant during the period 1978-1987. In contrast, the number of malignant melanoma localized to the extremities increases. For lower limb amputation the mean age is 58 y for males and for females, 72 y. The sex ratio, male to female is 1:2.2. Of the 13 male amputees 7 (54%) had died after 18 mo, of the 28 female amputees 20 (74%) had died after 19 mo. An analysis (Kaplan-Meier) shows a 5-y survival rate of about 28%. The mortality is found to be related to sex and level of amputation. Six cases of upper extremity amputation are presented. A review of the literature in order to compare the demographic factors and to outline the indications for amputation reveals a number of differences, most significantly the higher mean age at time of amputation (about 65 y) in Denmark than the figures earlier published (about 45 y). The consensus seems to be that amputation is rarely indicated except as a form of palliation.