Timely management of Melanoma may improve Overall & Melanoma-specific Mortality

A new investigation found that there were improved overall mortality rates and melanoma-specific mortality rates with the timely management of Melanoma. The study was published in the journal Journal of the American Academy of Dermatology.' 

There is not much data on the effect of the delay in treatment on melanoma outcomes. So, to assess the impact of surgical treatment delays on melanoma-specific mortality (MSM) and overall mortality (OM) researchers conducted a study on melanoma patients. Using the Surveillance, Epidemiology, and End Results database patients with stage I to III cutaneous melanoma were identified. There were about 1,08,689 patients identified. Included cases had time from diagnosis to definitive surgery and follow-up time. Cox proportional hazards and Fine-Gray competing risks analyses were used to assess the impact of treatment delays on mortality. 

Results: 

• Treatment delays of 3 to 5 months were associated with worse MSM and any delay beyond 1 month was associated with worse OM across all stages.
• Delays of 3 to 5 months were associated with worse MSM and any delay beyond 1 month was associated with worse OM in a subgroup analysis of patients with stage I disease.
• Worse MSM was found with delays of 6+ months and worse OM was seen with delays of 3 to 5 months in patients with stage II disease.
• No significant effect of treatment delays was noted in stage III disease.

Thus, the researchers concluded that timely treatment of melanoma may be associated with improved OM and MSM. They also mentioned certain limitations of the study like the lack of comprehensive data on adjuvant treatments, disease recurrence, or treatment failure from the Surveillance, Epidemiology, and End Results database. 

TAKE-HOME MESSAGE

Using the Surveillance, Epidemiology, and End Results database, the outcomes of patients with melanoma treated with local excision, Mohs micrographic surgery, or amputation were evaluated. The overall mortality across all stages increased with even a 1 to 2–month delay between diagnosis and treatment. Furthermore, the mortality risk increased concordantly with longer treatment delay. Notably, patients with stage I disease had a worse melanoma-specific and overall mortality, with delays in treatment over 30 days, compared with patients with stage II and stage III disease.

Prompt treatment of melanoma should be prioritized, as delays in treatment lead to increased mortality. 

Further reading, click here: https://doi.org/10.1016/j.jaad.2022.06.1190 

Xiong DD, Barriera-Silvestrini P, Knackstedt TJ. Delays in the surgical treatment of melanoma are associated with worsened overall and melanoma-specific mortality: A population-based analysis [published online ahead of print, 2022 Jul 1]. J Am Acad Dermatol. 2022; S0190-9622(22)02239-3.