TOPLINE:
Overall 5-year survival rates for American Indians and Alaska Natives diagnosed with melanoma were 75%, according to a study that used national data from 2004 to 2018.
METHODOLOGY:
- Data are lacking on the presentation and survival predictors of melanoma in American Indians (AI) and Alaska Natives (AN).
- Researchers queried the National Cancer Database between 2004 and 2018 for cases of biopsy-confirmed primary cutaneous invasive melanoma diagnosed among individuals who identified as AI/AN.
- Statistical analyses performed included Kaplan-Meier analysis and multivariable Cox regression.
TAKEAWAY:
- Of the 429 AI/AN individuals evaluated, 51.3% were women (mean age at diagnosis was 54 years), 72.3% had early-stage disease, 27.7% had late-stage disease, and 30.1% had the trunk as the most common primary site.
- Kaplan-Meier analysis revealed an overall survival of 75.0% at 5 years and 67.8% at 10 years, while the mean overall survival was 11.1 years. Overall 5-year survival rates were 92.1% for stage I melanoma, 71.6% for stage II melanoma, and 61.1% for stage III melanoma, but it was not reached for stage IV disease.
- Multivariable Cox regression revealed a 1.37-fold increased mortality for men compared with women, while the primary site with the highest mortality risk was the trunk (adjusted hazard ratio [aHR], 1.72), followed by the upper extremities (aHR, 1.63), and head and neck (aHR, 1.57), compared with the lower extremities. This is compared with predominantly White populations, where the head/neck is the primary site associated with the highest independent mortality risk.
IN PRACTICE:
"Rates of late-stage disease at diagnosis in our study were nearly double that of a smaller study, but as our sample size is nearly 10-fold (larger), our stages at diagnosis may be more representative of this population," the authors wrote.
SOURCE:
Corresponding author Ashley Wysong, MD, MS, of the University of Nebraska Medical Center Department of Dermatology, Omaha, led the research. The study was published online on December 1, 2023, in the Journal of the American Academy of Dermatology.
LIMITATIONS:
Data on disease-specific survival changes in melanoma treatment that might affect overall survival estimates are lacking. In addition, more is needed to identify modifiable factors affecting prognosis in AI/AN populations.
DISCLOSURES:
Dr Wysong disclosed that she is the recipient of the Institutional Research Grant for Castle Biosciences. There were no other disclosures and no funding source.
Comments