Melanoma treatment delays associated with increased mortality

Delays in melanoma treatment are associated with overall and melanoma-specific mortality, according to a study.

“The incidence of melanoma continues to rise in older individuals, with an estimated 100,350 new cases and 6,850 new deaths in 2020,” David D. Xiong, MD, of the University of Pittsburgh Medical Center, and colleagues wrote. “Prior studies have demonstrated varying effects of treatment delays on survival outcomes.”

Researchers conducted a population-based study that included 108,689 patients diagnosed with invasive melanoma in the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute between 2010 and 2016.

Patients who had a delay of 1 to 2 months between melanoma diagnosis and treatment had a significantly increased overall adjusted hazard ratio of all-cause mortality (HR = 1.09; 95% CI, 1.04-1.14; P = .001). Additionally, as delays continued, the hazard ratio increased as well.

Melanoma-specific mortality increased the greatest in phase 1 patients who delayed treatment 3 to 5 months (HR = 3.604; 95% CI, 2.435-5.334; P < .0001) and in phase 2 patients who delayed treatment 6 months or more (HR = 3.669; 95% CI, 1.951-6.901; P < .0001). No significant association between treatment delay and melanoma-specific mortality for stage 3 patients was found.

“Timely treatment of cutaneous melanoma may be associated with improved all-cause mortality and reduced incidence of disease specific death,” the authors wrote. “Delays in treatment of stage I melanomas as small as 1 month may be associated with significantly worsened [overall mortality], and delays of 3 to 5 months may be associated with worsened [melanoma-specific mortality].”