Outcomes for lymph node-positive cutaneous melanoma over two decades

Steve R. Martinez, Warren H. Tseng, Shawn E. Young

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Our aim was to demonstrate that, despite advances in treatment and surveillance of node-positive cutaneous melanoma, rates of overall survival (OS) and melanoma-specific survival (MSS) have not changed over the last two decades. Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute to identify patients with node-positive cutaneous melanoma. Patients were categorized by treatment era; the first era encompassed patients diagnosed from 1988 to 1999 and the second era 2000 to 2006. Multivariate Cox proportional hazards models compared rates of OS and MSS between treatment eras while controlling for known prognostic factors. We reported risks of death as hazard ratios (HR) with 95% confidence intervals (CI) and set significance at P ≤ 0.05. Results: Entrance criteria were met by 6,868 patients, 1,631 (23.8%) treated in era I and 5,237 (76.3%) treated in era II. On multivariate analysis, era II patients did not demonstrate a significantly different risk of death from any cause (HR 0.89, CI 0.79-1.01; P < 0.08), but they did have a lower risk of melanoma-specific mortality (HR 0.81, CI 0.71-0.93; P = 0.003) relative to their era I counterparts. Conclusions: Over nearly two decades, MSS but not OS has improved for AJCC stage III melanoma patients. Stage migration is likely responsible for any improvement in MSS among patients in the most recently diagnosed era.

Original languageEnglish (US)
Pages (from-to)1567-1572
Number of pages6
JournalWorld Journal of Surgery
Volume35
Issue number7
DOIs
StatePublished - Jul 2011

Fingerprint

Melanoma
Lymph Nodes
Skin
Survival
Confidence Intervals
Survival Rate
National Cancer Institute (U.S.)
Proportional Hazards Models
Cause of Death
Epidemiology
Therapeutics
Multivariate Analysis
Databases
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Outcomes for lymph node-positive cutaneous melanoma over two decades. / Martinez, Steve R.; Tseng, Warren H.; Young, Shawn E.

In: World Journal of Surgery, Vol. 35, No. 7, 07.2011, p. 1567-1572.

Research output: Contribution to journalArticle

Martinez, Steve R. ; Tseng, Warren H. ; Young, Shawn E. / Outcomes for lymph node-positive cutaneous melanoma over two decades. In: World Journal of Surgery. 2011 ; Vol. 35, No. 7. pp. 1567-1572.
@article{3bd7e4c2fc854f58a32eadc60819f100,
title = "Outcomes for lymph node-positive cutaneous melanoma over two decades",
abstract = "Background: Our aim was to demonstrate that, despite advances in treatment and surveillance of node-positive cutaneous melanoma, rates of overall survival (OS) and melanoma-specific survival (MSS) have not changed over the last two decades. Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute to identify patients with node-positive cutaneous melanoma. Patients were categorized by treatment era; the first era encompassed patients diagnosed from 1988 to 1999 and the second era 2000 to 2006. Multivariate Cox proportional hazards models compared rates of OS and MSS between treatment eras while controlling for known prognostic factors. We reported risks of death as hazard ratios (HR) with 95{\%} confidence intervals (CI) and set significance at P ≤ 0.05. Results: Entrance criteria were met by 6,868 patients, 1,631 (23.8{\%}) treated in era I and 5,237 (76.3{\%}) treated in era II. On multivariate analysis, era II patients did not demonstrate a significantly different risk of death from any cause (HR 0.89, CI 0.79-1.01; P < 0.08), but they did have a lower risk of melanoma-specific mortality (HR 0.81, CI 0.71-0.93; P = 0.003) relative to their era I counterparts. Conclusions: Over nearly two decades, MSS but not OS has improved for AJCC stage III melanoma patients. Stage migration is likely responsible for any improvement in MSS among patients in the most recently diagnosed era.",
author = "Martinez, {Steve R.} and Tseng, {Warren H.} and Young, {Shawn E.}",
year = "2011",
month = "7",
doi = "10.1007/s00268-010-0903-8",
language = "English (US)",
volume = "35",
pages = "1567--1572",
journal = "Presentations from the 9th Annual Electric Utilities Environmental Conference",
issn = "0364-2313",
publisher = "Springer New York",
number = "7",

}

TY - JOUR

T1 - Outcomes for lymph node-positive cutaneous melanoma over two decades

AU - Martinez, Steve R.

AU - Tseng, Warren H.

AU - Young, Shawn E.

PY - 2011/7

Y1 - 2011/7

N2 - Background: Our aim was to demonstrate that, despite advances in treatment and surveillance of node-positive cutaneous melanoma, rates of overall survival (OS) and melanoma-specific survival (MSS) have not changed over the last two decades. Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute to identify patients with node-positive cutaneous melanoma. Patients were categorized by treatment era; the first era encompassed patients diagnosed from 1988 to 1999 and the second era 2000 to 2006. Multivariate Cox proportional hazards models compared rates of OS and MSS between treatment eras while controlling for known prognostic factors. We reported risks of death as hazard ratios (HR) with 95% confidence intervals (CI) and set significance at P ≤ 0.05. Results: Entrance criteria were met by 6,868 patients, 1,631 (23.8%) treated in era I and 5,237 (76.3%) treated in era II. On multivariate analysis, era II patients did not demonstrate a significantly different risk of death from any cause (HR 0.89, CI 0.79-1.01; P < 0.08), but they did have a lower risk of melanoma-specific mortality (HR 0.81, CI 0.71-0.93; P = 0.003) relative to their era I counterparts. Conclusions: Over nearly two decades, MSS but not OS has improved for AJCC stage III melanoma patients. Stage migration is likely responsible for any improvement in MSS among patients in the most recently diagnosed era.

AB - Background: Our aim was to demonstrate that, despite advances in treatment and surveillance of node-positive cutaneous melanoma, rates of overall survival (OS) and melanoma-specific survival (MSS) have not changed over the last two decades. Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute to identify patients with node-positive cutaneous melanoma. Patients were categorized by treatment era; the first era encompassed patients diagnosed from 1988 to 1999 and the second era 2000 to 2006. Multivariate Cox proportional hazards models compared rates of OS and MSS between treatment eras while controlling for known prognostic factors. We reported risks of death as hazard ratios (HR) with 95% confidence intervals (CI) and set significance at P ≤ 0.05. Results: Entrance criteria were met by 6,868 patients, 1,631 (23.8%) treated in era I and 5,237 (76.3%) treated in era II. On multivariate analysis, era II patients did not demonstrate a significantly different risk of death from any cause (HR 0.89, CI 0.79-1.01; P < 0.08), but they did have a lower risk of melanoma-specific mortality (HR 0.81, CI 0.71-0.93; P = 0.003) relative to their era I counterparts. Conclusions: Over nearly two decades, MSS but not OS has improved for AJCC stage III melanoma patients. Stage migration is likely responsible for any improvement in MSS among patients in the most recently diagnosed era.

UR - http://www.scopus.com/inward/record.url?scp=80051544397&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051544397&partnerID=8YFLogxK

U2 - 10.1007/s00268-010-0903-8

DO - 10.1007/s00268-010-0903-8

M3 - Article

C2 - 21559997

AN - SCOPUS:80051544397

VL - 35

SP - 1567

EP - 1572

JO - Presentations from the 9th Annual Electric Utilities Environmental Conference

JF - Presentations from the 9th Annual Electric Utilities Environmental Conference

SN - 0364-2313

IS - 7

ER -