A population-based study found that delaying treatment for melanoma was associated with worse mortality outcomes. These findings were published in the Journal of the American Academy of Dermatology.

Incidence of melanoma continues to increase among older adults and is among the most common malignancies diagnosed among men and women in the United States. In this study, the investigators tested the hypothesis that increased delays in treatment is associated with poorer overall survival and higher disease-specific mortality.

Data for this study were sourced from the Surveillance, Epidemiology, and End Results (SEER) program, which was collected between 2010 and 2016 by the National Cancer Institute. Patients (N=108,689) with stages I-III cutaneous melanoma were evaluated for mortality outcomes on the basis of time from diagnosis to definitive surgery.

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The study population comprised 58.94% men, 47.62% were aged 65 years and older, the most common lesion location was the trunk (33.51%), and the most common stage at diagnosis was IA (42.68%).

At an average follow-up of 35.37 months, 89.03% of patients were alive, 6.20% had melanoma-associated mortality, and 7.23% had nonmelanoma-associated mortality.

All-cause mortality was associated with 1- to 2-month (hazard ratio [HR], 1.09; P =.001) and 3- to 5-month (HR, 1.5; P <.0001) delays in treatment.

Melanoma-specific mortality was associated with 1- to 2-month (HR, 1.36; P =.0003), 2- to 3-month (HR, 1.637; P =.0009), and 3- to 5-month (HR, 3.604; P <.0001) delays in treatment.

In the multivariate analysis, across all melanoma stages delaying treatment for 3 to 5 months increased risk for melanoma-specific mortality (HR, 1.315; P =.02).

The major limitation of this study was that the SEER database had incomplete information about adjuvant therapy.

The results of this study supported the investigators hypothesis that delaying treatment after melanoma diagnosis increased risk for all-cause and melanoma-specific mortality.


Xiong DD, Barriera-Silvestrini P, Knackstedt TJ. Delays in the surgical treatment of melanoma are associated with worsened overall and melanoma-specific mortality: a population-based analysis. J Am Acad Dermatol. Published online July 1, 2022. doi:10.1016/j.jaad.2022.06.1190