Norwegian Melanoma Registry

Summary from the annual report 2025

The National Clinical Registry for Melanoma publishes national results for cutaneous melanoma, at institutional level, for the thirteenth time in this annual report. The registry has data on melanoma cases for the period 2008–2025, but The Melanoma Registry was first given granted national status in 2013.

In 2025, 3696 cases of melanomas were registered, of which 3587 were cutaneous melanomas. Furthermore, 85 cases of eye melanoma and 24 mucosal melanomas. Cutaneous melanoma is the most serious form of skin cancer and is among the cancers that are increasing the most in Norway.

The coverage rate for clinical reporting in 2025 is 84.4 %. This is very encouraging as one of the registry’s quality goals is a coverage rate of at least 80 %, and for several years we have focused on increasing reporting from the hospitals. Various measures to improve the reporting rate have resulted in an improvement, especially that of establishing local contacts at the hospitals. It takes time to establish good reporting routines, and this will still be a focus area for the melanoma registry in the years to come.

The proportion of patients with pathologically free margins after primary excision is 73.8 % among the general practitioners (GPs), in comparision it is 85.8 % in hospitals. The expert group believes that a desirable level is ≥ 85 %. The largest patient group removes their melanoma at GPs and private clinics, and the results for GPs are far below the desirable level. Some hospitals are planning, or have already conducted, educational sessions for general practitioners, and the results from the annual report are also highlighted when the Melanoma Registry presents the report to the medical directors in the regional health trusts. We hope that these efforts will contribute to increasing the level of knowledge about melanomas among general practitioners and private clinics, and to strengthening dermatology resources in Norway. These are important measures both for early detection of melanoma and for improving the rate of correctly performed primary excisions. 

An important quality goal to prevent local recurrence is that patients who undergo extended excision have the melanoma removed with a sufficient margin of healthy tissue as described in the National Treatment Guidelines. In Norway, this proportion is now within a high target of 90.6 %. There may be several reasons why melanoma is removed with more or less margin around the suspected lesion than the guidelines state. An example could be that the melanoma is in an area where removing a lot of skin and tissue would compromise function and aesthetics, such as in the head and neck region. We see that there is some variation between hospitals, and the registry has contacted the hospitals that do not achieve the desired level.

It is beneficial for the patient to have the diagnosis made as early as possible– preferably in stage T1– as these normally have very good survival after surgery alone. T1 is characterised by the melanoma being 1 mm or thinner. The Advisory Board has set a quality target that at least 60 % of the melanomas that are removed should be in stage T1. Theresults show that in Norway the proportion is 58.6 %.

In this annual report, we have chosen to divide the quality indicator for the proportion of patients receiving wide excision within 35 days into the stage groups pT1 and ≥ pT2a. The aim is to examine whether waiting times differ between these patient groups. Patients with pT1 are referred directly for wide excision, whereas patients with ≥ pT2a are admitted for shared decision-making regarding sentinel lymph node biopsy prior to wide excision. Nationally, 66.4 % of patients with pT1 and 51.2 % of patients with ≥ pT2a received wide excision within 35 days, which is well below the quality target of ≥ 80 %. Nevertheless, it is encouraging to see that several health trusts have improved their waiting times compared with previous years after being made aware of their own result.

The expert group wants to monitor the quality of assessment and treatment of patients with metastatic melanoma. The proportion of patients in stages III and IV who were discussed in MDT meetings (multidisciplinary team) before treatment decisions show that there is some variation between hospitals.

In last year’s report, we included several new figures based on drug treatments in patients with metastatic disease. These figures have been continued in this year’s report to allow monitoring these results over time. Some examples of this are the proportion of patients who have received neoadjuvant treatment with complete pathological response, the proportion of patients over 74 years of age who have received adjuvant treatment, and drug tumor-directed treatment given to melanoma patients in the last eight weeks before death. We want to take a closer look at the figures in chapter 2.7.2 and plan to develop target numbers and new quality indicators.

This year’s report presents results on patient-reported outcome and experience measures for the fifth time. The quality indicator measuring the proportion of patients who were satisfied with the hospital’s treatment services shows that 88.4 % of respondents in the population survey were satisfied with the treatment provided.

The five-year relapse-free survival among patients in stages I and II is also very good, 83 % in Norway. As some relapses are only clinically verified, and not necessarily reported to the registry, we have linked data from the Norwegian Patient Registry, to ensure complete information. 

The five-year relative survival among patients in stages IIB and IIC is within the high target level of 74.4 %. As expected, this result is almost unchanged from previous year’s report, but we look forward to following developments for these stages where we hope for good medical treatment in the years ahead. 

Due to the small number of cases of ocular- and mucosal melanoma, we do not publish comprehensive analyses for these patient groups annually. Although incidence and survival data are reported each year, this year’s report presents more extensive results, last presented in the 2021 annual report.