Analysis of Risk Factors for Death from Melanoma and Genitourinary Diseases in Male Patients with Cutaneous Melanoma: A Cohort Propensity Score Matching Study.

Abstract

To analyze the influencing factors of male cutaneous melanoma (CM) patients dying from genitourinary diseases (GUD). We searched the surveillance, epidemiology, and end results (SEER) database and extracted data on male CM patients according to the inclusion and exclusion criteria, including male patients whose cause of death was CM (cohort A) or GUD (cohort B). Comparisons between the two cohorts were performed before and after propensity score matching (PSM). An interaction analysis between age and year of diagnosis was also conducted. Cox regression analysis were performed to find the risk factors for death from GUD. Seven thousand seventy-eight CM patients were included, including 6415 (90.6%) in cohort A and 663 (9.4%) in cohort B. Compared with cohort A, cohort B patients were older (median age 74 ys. vs 65 ys.) and were more under the localized stage and had longer survival time no matter before or after PSM (all p<0.001). The stage was an inhibitory factor for cohort B (p <0.001). After PSM, only age and year of diagnosis were found to be cohort B's promoting factors (p<0.001). The interaction analysis showed that older patients diagnosed in later years (2009-2020) had a higher risk of dying from GUD compared to those diagnosed earlier (p<0.05). Patients with a later year of diagnosis (2009-2020) had a lower median survival time than patients with an earlier year of diagnosis (2000-2008) (p<0.001). When the patient's year of diagnosis was earlier (2000-2008), older patients (>75 ys.) had a higher risk of dying from GUD than younger patients (≤75 ys.) (p<0.001). We first reported a significant interaction between age and year of diagnosis in male CM patients dying from GUD, highlighting the increased risk in older patients diagnosed more recently. We may pay attention to the possibility of dying from genitourinary diseases for CM patients.