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. 2024 Nov 22;16(11):e74247.
doi: 10.7759/cureus.74247. eCollection 2024 Nov.

Patient and Tumor Factors on Overall Survival in Spindle Cell Melanoma

Xinxin Wu  1 , Peter T Silberstein  2
Affiliations

Patient and Tumor Factors on Overall Survival in Spindle Cell Melanoma

Xinxin Wu et al. Cureus. .

Abstract

Introduction: Spindle cell melanoma (SCM) is a rare melanoma subtype characterized histologically by atypical, spindled, malignant melanocytes. SCM often presents in older patients and lacks typical cytologic markers, complicating diagnosis and frequently leading to advanced disease upon presentation. While some studies have documented SCM incidence, none have thoroughly examined the demographic, socioeconomic, and treatment factors influencing survival outcomes.

Objective: This study aims to investigate how demographic and clinical factors affect overall survival outcomes in SCM, providing updated data on demographic, socioeconomic, and tumor-related characteristics and treatment patterns.

Methods: This retrospective cohort study analyzed histologically confirmed spindle cell melanoma and mixed spindle cell melanoma cases diagnosed between 2004 and 2021. Patient demographic, socioeconomic, and clinical factors were collected, and multivariate Cox regression analysis was performed to determine the effects on overall survival.

Results: Among 9,210 SCM cases, most were White patients (97.5%), male (65.2%), and located in metropolitan areas (85.7%). Males were more likely to receive treatment at academic centers and have higher comorbidity scores. The average age at diagnosis was 67.3 years (SD±15.1). SCM in head and neck regions showed a worse prognosis compared to extremity melanomas. Surgical intervention, received by 84.9% of patients, was associated with improved overall survival. The minority of patients who received radiation and chemotherapy (13.2% and 3.3%, respectively) were linked to increased mortality risk.

Conclusion: Age, sex, insurance status, treatment facility type, tumor location, and stage significantly influence SCM survival outcomes. The findings suggest that SCM's prognosis is closely tied to demographic and clinical characteristics, similar to other melanoma subtypes, supporting standard treatment protocols with surgical intervention as the primary approach. This large-scale study leverages comprehensive NCDB data, contributing to the literature gap in SCM's treatment and management.

Keywords: demographics; health disparity; overall survival; skin cancer; spindle cell melanoma.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Creighton University Institutional Review Board (IRB) issued approval 2003680-01. Creighton University Institutional Review Board (IRB) has determined that this project, under submission number 2003680-01, does not involve human subjects under 45 CFR46.102(e), and an IRB review was not required. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This project is funded in part by the National Institutes of Health, Community-Oriented Primary Care Endowment (NIH#5S21MD001102-03), and Creighton University Health Sciences Multicultural and Community Affairs, Community-Oriented Primary Care Program (Dr. Sade Kosoko-Lasaki/PI). No other specific grant from funding agencies in the public, commercial, or not-for-profit sectors was received. The other funding source was self. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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