Five-year survival in patients with nodular and superficial spreading melanomas in the US population - 17/02/21

Doi : 10.1016/j.jaad.2020.11.047

Blair S. Allais, MD ^a,^⁎ , Meghan Beatson, MD ^b, Hongkun Wang, PhD ^c, Shandiz Shahbazi, MD ^d, Lana Bijelic, MD ^e, Sekwon Jang, MD ^f,^g, Suraj Venna, MD ^f,^g
^a Washington University Department of Dermatology, Washington, DC
^b Memorial Sloan Kettering Cancer Center Department of Medicine, New York, NY
^c Georgetown University Departments of Biostatistics, Bioinformatics, and Biomathematics, Washington, DC
^d Georgetown University Departments of Medicine, Washington, DC
^e Hospital de Sant Joan Despi Moises Broggi, Barcelona, Spain
^f University of Virginia School of Medicine, Charlottesville, VA
^g Inova Melanoma and Skin Cancer Center, Inova Schar Cancer Institute, Fairfax, VA

^∗Correspondence to: Blair S. Allais, MD, George Washington University Department of Dermatology, 2150 Pennsylvania Ave NW, Suite 2B-430, Washington, DC 20037.George Washington University Department of Dermatology2150 Pennsylvania Ave NWSuite 2B-430WashingtonDC20037

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Abstract

Background

Although superficial spreading melanomas (SSM) are diagnosed as thinner lesions, nodular melanomas (NM) have a more rapid growth rate and are biologically more aggressive compared with other histologic subtypes.

Objective

To determine the difference in 5-year relative survival in patients with NM and SSM at the same Breslow depth and TNM stage.

Methods

A population-based cross-sectional analysis compared the 5-year relative survival of patients with NM and SSM using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)∗Stat software (version 8.2.1-8.3.5). Chi-square tests compared the proportions, and Kaplan-Meier method with Z-score compared 5-year relative survival.

Results

For patients receiving a diagnosis between 2004 and 2009, 5-year relative survival was lower in NM compared with SSM (53.7% vs 87.3%; Z score, –41.35; P < .001). Similarly, for patients receiving a diagnosis between 2010 and 2015, 5-year relative survival was lower in NM compared with SSM (61.5% vs 89.7%; Z score, –2.7078; P < .01). Subgroup analyses showed inferior survival in NM in T1b, and survival differences remained significant after excluding patients with nodal or distant metastases.

Conclusions

Five-year relative survival is worse in NM compared with SSM especially in T1b, T2a, and T2b melanomas. Melanoma subtype should be taken into consideration when making treatment recommendations.

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Key words : 5-year survival, nodular melanoma, overall survival, superficial spreading melanoma

Abbreviations used : AJCC, CI, HR, NM, SEER, SLN, SLNB, SSM