Cutaneous melanoma diagnosis may impact total life expectancy

Key takeaways:

• Patients with stage II or III cutaneous melanoma lost a total of 2,209 and 1,902 life-years, respectively.
• Loss of life expectancy increased with higher substages within stage II and stage III disease.

Evaluating the loss of life expectancy among patients diagnosed with cutaneous melanoma may help establish a lifetime prognosis for patients, according to a study.

“Commonly reported measures (5-year disease-free survival/relative survival ratio, and overall survival) are useful for summarizing cancer prognosis,” Sofi Vikström, MD, of the department of oncology-pathology at the Karolinska Institute and the department of pathology and cancer diagnostics at Karolinska Solna University Hospital in Sweden, and colleagues wrote. “These do not capture the impact of a cancer diagnosis based on the entire remaining lifespan.”

To investigate the loss of life expectancy (LLE) among patients aged 40 to 80 years with stage II through III cutaneous melanoma (CM) in Sweden, the authors conducted a population-based cohort study.

The study included data from the Swedish Melanoma Registry on 8,061 patients diagnosed with CM between 2005 and 2018.

Results showed that patients with stage II or III CM lost a total of 2,209 and 1,902 life-years, respectively. LLE was higher in women aged 60 years with stage III vs. stage II disease (5.2 years; 95% CI, 4.3-6.2 vs. 10.9 years; 95% CI, 9-12.5 years) and in men with stage II disease aged 40 years vs. 70 years (10.7 years; 95% CI, 7-14 vs. 3.9 years; 95% CI, 3.5-4.3).

In patients aged 50 years with stage II disease, women had a lower LLE compared with men (7.3 years; 95% CI, 5.6-9 vs. 8.3 years; 95% CI, 6.7-9.8).

LLE increased with higher substages within stage II and stage III disease. The authors found, for examples, that a man aged 60 years with stage II CM loses 4.6 years (95% CI, 3.4-5.7) of life expectancy at stage IIA, 7.1 years (95% CI, 5.8-8.3) at stage IIB, and 9.6 years (95% CI, 7.9-11.1) at stage IIC. A similar pattern was seen among patients with stage III disease.

“By using novel absolute and proportional measures of LLE, we illustrate the impact of CM on the whole lifespan and demonstrate the unmet needs of operated high-risk CM,” the authors wrote. “Importantly, LLE provides easily understood information about the prognosis to the health care and the CM patients, which is critical for communicating and understanding the disease.”