Publikationsdatum:
2020-09-14
Beschreibung:
Background Survival from metastatic cutaneous melanoma is substantially lower than for localised 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-term survival 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 log-hazard scale to estimate the effect of race on the hazard of death due to melanoma, and estimated 1-year net survival by race. Results Only 4.4% of the 425,915 melanomas were diagnosed at a distant stage, with higher proportions in men, older patients and African Americans. Age-standardised 1-year net survival for distant-stage disease was stable at around 43% during 2001-2010. From 2010 onwards, survival improved rapidly, reaching 58.9% (95% confidence interval [CI] = 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.
Digitale ISSN:
2515-5091
Thema:
Chemie und Pharmazie
,
Medizin
Permalink
