34269 Comparison of survival in women with melanoma by race and ethnicity: An analysis of the National Cancer Database 2004-2018

Abstract

Background: Survival in melanoma is better in women than men. Race and ethnicity also appear to play a role in melanoma survival. However, less is known about how race/ethnicity impacts survival among women. Methods: The National Cancer Database was queried for cases of invasive melanoma as the only malignancy diagnosed between 2004-2018 in women who were non-Hispanic (NH) White, NH Black, NH Asian, or Hispanic. Statistical tests included Chi-squared (categorical variables), Kruskal-Wallis (numeric variables), and Kaplan-Meier curves and log-rank test (overall survival, OS). Results: The 163,104 cases were comprised of 97.0% Whites, 0.9% Blacks, 0.4% Asians, and 1.7% Hispanics. Hispanics were diagnosed at the lowest median age in years (53), followed by Asians (54), Whites (56), and Blacks (61; P < .001). The 5-year OS was highest for Whites (84.7%), followed by Hispanics (78.8%), Asians (75.2%), and Blacks (65.0%; P < .001). Race/ethnicity was associated with stage at diagnosis, with a higher rate of Whites being diagnosed with stage I disease (69.0%), followed by Asians (50.7%), Hispanics (49.6%), and Blacks (35.4%; P < .001). Blacks had the highest median Breslow depth (1.60 mm), followed by Asians (1.15 mm), Hispanics (1.00 mm), and Whites (0.73 mm; P < .001). Blacks had the highest rates of regional lymph node positivity (20.6%) and distant metastasis (14.3%). Of histologic subtypes, Blacks were diagnosed with acral lentiginous melanoma (21.0%) more frequently than Asians (12.0%), Hispanics (9.0%), or Whites (1.4%). Conclusions: Among women diagnosed with melanoma, Blacks are diagnosed later in life with a higher stage, and overall survival was worse than other races/ethnicities.