Ten-year survival after multiple invasive melanomas is worse than after a single melanoma: a population-based study

Youlden, Danny R., Baade, Peter D., Soyer, H. Peter, Youl, Philippa H., Kimlin, Michael G., Aitken, Joanne F., Green, Adele C. and Khosrotehrani, Kiarash (2016) Ten-year survival after multiple invasive melanomas is worse than after a single melanoma: a population-based study. Journal of Investigative Dermatology, 1-8. doi:10.1016/j.jid.2016.03.014


Author Youlden, Danny R.
Baade, Peter D.
Soyer, H. Peter
Youl, Philippa H.
Kimlin, Michael G.
Aitken, Joanne F.
Green, Adele C.
Khosrotehrani, Kiarash
Title Ten-year survival after multiple invasive melanomas is worse than after a single melanoma: a population-based study
Journal name Journal of Investigative Dermatology   Check publisher's open access policy
ISSN 0022-202X
1523-1747
Publication date 2016-03-24
Sub-type Article (original research)
DOI 10.1016/j.jid.2016.03.014
Open Access Status Not Open Access
Start page 1
End page 8
Total pages 8
Place of publication London, United Kingdom
Publisher Nature Publishing Group
Collection year 2017
Language eng
Formatted abstract
The prognosis of melanoma patients who are diagnosed with multiple primary lesions remains controversial. We used a large population-based cohort to re-examine this issue, applying a delayed entry methodology to avoid survival bias. Of 32,238 eligible patients diagnosed between 1995 and 2008, 29,908 (93%) had a single invasive melanoma, 2,075 (6%) had two, and 255 (1%) had three. Allowing for differences in entry time, 10-year cause-specific survival for these three groups was 89% (95% confidence interval [CI] = 88–90%), 83% (95% CI = 80–86%), and 67% (95% CI = 54–81%), respectively. After adjustment for key prognostic factors, the hazard ratio of death within 10 years from melanoma was two times higher for those with two melanomas (hazard ratio = 2.01, 95% CI = 1.57–2.59; P < 0.001) and nearly three times higher when three melanomas were diagnosed (hazard ratio = 2.91, 95% CI = 1.64–5.18; P < 0.001) compared with people with a single melanoma. Melanoma-specific mortality remained elevated after adjusting for maximum thickness or ulceration of any melanoma regardless of the index tumor. After appropriately accounting for the interval between diagnosis of the first and subsequent melanomas, patients with multiple invasive melanomas have significantly poorer survival than patients with a single invasive melanoma.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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Created: Mon, 01 Aug 2016, 10:26:57 EST by Professor Peter Soyer on behalf of School of Medicine