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Early melanoma treatment improves outcomes

21 Dec 2017

Speedy treatment of stage I melanoma is likely to result in improved outcomes, suggests a recent study.

Multivariate analysis revealed that patients in all stages who were treated between 90 and 119 days following biopsy (hazard ratio [HR], 1.09; 95 percent CI, 1.01‒1.18) and >119 days (HR, 1.12; 1.02‒1.22) had a greater risk for mortality vs those treated within 30 days of biopsy.

A subgroup analysis of patients with stage I melanoma showed a higher mortality risk among those treated within 30 to 59 days (HR, 1.05; 1.01‒1.1), 60 to 89 days (HR, 1.16; 1.07‒1.25), 90 to 119 days (HR, 1.29; 1.12‒1.48), and >119 days after biopsy (HR, 1.41; 1.21‒1.65). In stages II and III, surgical timing had no impact on survival.

“Patient concern for receiving immediate treatment often exceeds surgeon or hospital availability, requiring establishment of a safe window for melanoma surgery,” researchers said.

In this study that examined the impact of time to definitive melanoma surgery on overall survival, patients with stage I to III cutaneous melanoma and with available time to definitive surgery and overall survival were identified using the National Cancer Database (n=153,218). Researchers compared variables using the t test and chi-square test. Cox regression was used for multivariate analysis.

The findings of this study should be viewed in light of certain limitations, such as the absence of melanoma-specific survival, according to researchers.

An earlier study showed that time interval of up to 3 months between melanoma diagnosis and sentinel node (SN) biopsy had no impact on 5-year survival or SN positivity rate. This finding can be used to counsel patients and remove strict time limits from melanoma guidelines, said researchers. [Eur J Cancer 2016;67:164-173]

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