Survival outcomes of patients with advanced melanoma from 2013 to 2017: results of a nationwide population-based registry

Zeijl, M.C.T. van; Wreede, L.C. de; Eertwegh, A.J.M. van den; Wouters, M.W.J.M.; Jochems, A.; Schouwenburg, M.G.; ... ; Haanen, J.B.A.G. (2021)

Article / Letter to editor

Background: The treatment landscape has completely changed for advanced melanoma. We report survival outcomes and the differential impact of prognostic factors over time in daily clinical practice.Methods: From a Dutch nationwide population-based registry, patients with advanced melanoma diagnosed from 2013 to 2017 were analysed (n = 3616). Because the proportional hazards assumption was violated, a multivariable Cox model restricted to the first 6 months and a multivariable landmark Cox model from 6 to 48 months were used to assess overall survival (OS) of cases without missing values. The 2017 cohort was excluded from this analysis because of the short follow-up time.Results: Median OS of the 2013 and 2016 cohort was 11.7 months (95% confidence interval [CI]: 10.4-13.5) and 17.7 months (95% CI: 14.9-19.8), respectively. Compared with the 2013 cohort, the 2016 cohort had superior survival in the Cox model from 0 to 6 months (hazard ratio [HR] = 0.55 [95% CI: 0.43-0.72]) and in the Cox model from 6 to 48 months (HR = 0.68 [95% CI: 0.57-0.83]). Elevated lactate dehydrogenase levels, distant metastases in >= 3 organ sites, brain and liver metastasis and Eastern Cooperative Oncology Group performance score of >= 1 had stronger association with inferior survival from 0 to 6 months than from 6 to 48 months. BRAF-mutated melanoma had superior survival in the first 6 months (HR = 0.50 [95% CI: 0.42-0.59]).Conclusion(s): Prognosis for advanced melanoma in the Netherlands has improved from 2013 to 2016. Prognostic importance of most evaluated factors was higher in the first 6 months after diagnosis. BRAF-mutated melanoma was only associated with superior survival in the first 6 months. (C) 2020 Elsevier Ltd. All rights reserved.

• Advanced melanoma
• Immunotherapy
• Targeted therapy
• Real-world
• Nationwide
• Population-based

• All authors: Zeijl, M.C.T. van; Wreede, L.C. de; Eertwegh, A.J.M. van den; Wouters, M.W.J.M.; Jochems, A.; Schouwenburg, M.G.; Aarts, M.J.B.; Akkooi, A.C.J. van; Berkmortel, F.W.P.J. van den; Groot, J.W.B. de; Hospers, G.A.P.; Kapiteijn, E.; Piersma, D.; Rijn, R.S. van; Suijkerbuijk, K.P.M.; Tije, A.J. ten; Veldt, A.A.M. van der; Vreugdenhil, G.; Hoeven, J.J.M. van der; Haanen, J.B.A.G.
• Date: 2021-02-01
• Journal: European Journal of Cancer
• Volume: 144
• Pages: 242 - 251
• DOI: doi:10.1016/j.ejca.2020.11.028
• Link: https://pure.rug.nl/ws/files/157201205/Survival_outcomes_of_patients_wit...