Abstract

BackgroundFavorable survival in malignant cutaneous melanoma (melanoma) has increased the likelihood of second primary cancer (SPC). We assess the influence of patient characteristics at diagnosis of first melanoma and the type of SPC (second melanoma and other SPC) on overall survival.MethodsWe used the Swedish Cancer Registry data to assess overall survival in melanoma for the period 1990 to 2015. Kaplan-Meier curves were plotted and hazard ratios (HRs) were estimated with Cox regression models by considering SPC diagnosis as a time-dependent variable.ResultsA total of 46,726 patients were diagnosed with melanoma, and 15.3% of them developed SPC, among which, two thirds were other SPCs. Second melanomas were diagnosed early (31% during the first year) compared to non-melanoma SPCs (9.5%). Survival for women with second melanoma or other SPC (56 and 21% alive after 25 years of follow-up, respectively) exceeded the male rates (21 and 10%, respectively) but all these figures were lower than for females (60% alive) or males (48%) without SPC. Time dependent analysis showed vastly increased HRs for cancer types that are fatal also as first cancers, but SPC-specific HRs remained relatively uniform, irrespective of SPC diagnosed soon or late after first melanoma. In early-onset melanoma, SPC diagnosis after 10 years may not negatively influence overall survival.ConclusionsAs the overall survival of patients with many types of SPCs is unfavorable, advice about health lifestyle should benefit smoking patients and early detection methods may be recommended for SPCs of the breast, prostate and colorectum.

Highlights

  • Survival rates in malignant cutaneous melanoma have improved in Europe and North America at the same time when there has been an increase in incidence [1,2,3]

  • Patients diagnosed with histology-verified first primary invasive melanoma between 1990 and 2015 were identified in Swedish Cancer Registry according to International Classification of Diseases 7th revision (ICD-7) and they were followed for diagnosis of any of the 35 different second primary cancer (SPC) including second melanomas

  • Patients were stratified based on their time from first melanoma to SPC; hazard ratios (HRs) were estimated according to diagnosis of SPC

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Summary

Introduction

Survival rates in malignant cutaneous melanoma (subsequently ‘melanoma’) have improved in Europe and North America at the same time when there has been an increase in incidence [1,2,3]. That study showed that SPCs interfere with overall favorable survival in melanoma. We want to characterize the relationships for overall survival depending on gender, age at diagnosis and time interval between first melanoma and common types of SPCs using data from the Swedish Cancer Registry. Favorable survival in malignant cutaneous melanoma (melanoma) has increased the likelihood of second primary cancer (SPC). We assess the influence of patient characteristics at diagnosis of first melanoma and the type of SPC (second melanoma and other SPC) on overall survival

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