Delays in the surgical treatment of melanoma are associated with worsened overall and melanoma-specific mortality: A population-based analysis

Abstract

Background: The effect of treatment delays on melanoma outcomes remains unclear.

Objective: To assess the impact of surgical treatment delays on melanoma-specific mortality (MSM) and overall mortality (OM).

Methods: Patients with stage I to III cutaneous melanoma were identified through the Surveillance, Epidemiology, and End Results database (N = 108,689). Included cases had time from diagnosis to definitive surgery and follow-up time. Cox proportional hazards and Fine-Gray competing risks analyses were used to assess the impact of treatment delays on mortality.

Results: Across all stages, treatment delays of 3 to 5 months were associated with worse MSM and any delay beyond 1 month was associated with worse OM. In a subgroup analysis of patients with stage I disease, delays of 3 to 5 months were associated with worse MSM and any delay beyond 1 month was associated with worse OM. In patients with stage II disease, worse MSM was found with delays of 6+ months and worse OM was seen with delays of 3 to 5 months. No significant effect of treatment delays was noted in stage III disease.

Limitations: The Surveillance, Epidemiology, and End Results database does not collect comprehensive data on adjuvant treatments, disease recurrence, or treatment failure.

Conclusion: Timely treatment of melanoma may be associated with improved OM and MSM.

Keywords: SEER database; disease-specific mortality; melanoma; mortality; time to surgery; time to treatment; treatment delays.