Determination of the impact of melanoma surgical timing on survival using the National Cancer Database - 13/12/17
Abstract |
Background |
The ideal timing for melanoma treatment, predominantly surgery, remains undetermined. Patient concern for receiving immediate treatment often exceeds surgeon or hospital availability, requiring establishment of a safe window for melanoma surgery.
Objective |
To assess the impact of time to definitive melanoma surgery on overall survival.
Methods |
Patients with stage I to III cutaneous melanoma and with available time to definitive surgery and overall survival were identified by using the National Cancer Database (N = 153,218). The t test and chi-square test were used to compare variables. Cox regression was used for multivariate analysis.
Results |
In a multivariate analysis of patients in all stages who were treated between 90 and 119 days after biopsy (hazard ratio [HR], 1.09; 95% confidence interval [CI], 1.01-1.18) and more than 119 days (HR, 1.12; 95% CI, 1.02-1.22) had a higher risk for mortality compared with those treated within 30 days of biopsy. In a subgroup analysis of stage I, higher mortality risk was found in patients treated within 30 to 59 days (HR, 1.05; 95% CI, 1.01-1.1), 60 to 89 days (HR, 1.16; 95% CI, 1.07-1.25), 90 to 119 days (HR, 1.29; 95% CI, 1.12-1.48), and more than 119 days after biopsy (HR, 1.41; 95% CI, 1.21-1.65). Surgical timing did not affect survival in stages II and III.
Limitations |
Melanoma-specific survival was not available.
Conclusion |
Expeditious treatment of stage I melanoma is associated with improved outcomes.
Le texte complet de cet article est disponible en PDF.Key Words : melanoma, National Cancer Database, stage I melanoma, survival, time to surgery, time to treatment
Abbreviations used : CoC, LVI, MM, NCDB, OS, SLNB, TTI
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
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| Reprints not available from the authors. |
Vol 78 - N° 1
P. 40 - janvier 2018 Retour au numéro
Article précédent
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