Trends in short-term survival from distant-stage cutaneous melanoma in the United States, 2001-2013 (CONCORD-3)

Veronica Di Carlo, Jacques Esteve, Christopher Johnson, Fabio Girardi, Hannah K. Weir, Reda J. Wilson, Pamela Minicozzi, Rosemary D. Cress, Charles F. Lynch, Karen S. Pawlish, Judith R. Rees, Michel P. Coleman, Claudia Allemani

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Survival from metastatic cutaneous melanoma is substantially lower than for localized disease. Treatments for metastatic melanoma have been limited, but remarkable clinical improvements have been reported in clinical trials in the last decade. We described the characteristics of US patients diagnosed with cutaneous melanoma during 2001-2013 and assessed trends in short-termsurvival for distant-stage disease. Methods: Trends in 1-year net survival were estimated using the Pohar Perme estimator, controlling for background mortality with life tables of all-cause mortality rates by county of residence, single year of age, sex, and race for each year 2001-2013. We fitted a flexible parametric survival model on the loghazard scale to estimate the effect of race on the hazard of death because of melanoma and estimated 1-year net survival by race. Results: Only 4.4% of the 425 915 melanomas were diagnosed at a distant stage, cases diagnosed at a distant stage are more commonly men, older patients, and African Americans. Age-standardized, 1-year net survival for distant-stage disease was stable at approximately 43% during 2001-2010. From 2010 onward, survival improved rapidly, reaching 58.9% (95% confidence interval 56.6% to 61.2%) for patients diagnosed in 2013. Younger patients experienced the largest improvement. Survival for distant-stage disease increased in both Blacks and Whites but was consistently lower in Blacks. Conclusions: One-year survival for distant-stage melanoma improved during 2001-2013, particularly in younger patients and those diagnosed since 2010. This improvement may be a consequence of the introduction of immune-checkpoint-inhibitors and other targeted treatments for metastatic and unresectable disease. Persistent survival inequalities exist between Blacks and Whites, suggesting differential access to treatment.

Original languageEnglish (US)
Article numberpkaa078
JournalJNCI Cancer Spectrum
Volume4
Issue number6
DOIs
StatePublished - 2021
Externally publishedYes

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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