Conditional survival estimates improve over time for patients with advanced melanoma: results from a population-based analysis.
BACKGROUND
Conditional survival (CS) has emerged as a clinically relevant measure of prognosis for cancer survivors. The objective of this analysis was to provide melanoma-specific CS estimates to help clinicians promote more informed patient decision making.


METHODS
Patients with melanoma and at least 5 years of follow-up were identified from the Surveillance Epidemiology and End Results registry (1988-2000). By using the methods of Kaplan and Meier, stage-specific, 5-year CS estimates were independently calculated for survivors for each year after diagnosis. Stage-specific multivariate Cox regression models including baseline survivor functions were used to calculate adjusted melanoma-specific CS for different subgroups of patients further stratified by age, gender, race, marital status, anatomic tumor location, and tumor histology.


RESULTS
Five-year CS estimates for patients with stage I disease remained constant at 97% annually, while for patients with stages II, III, and IV disease, 5-year CS estimates from time 0 (diagnosis) to 5 years improved from 72% to 86%, 51% to 87%, and 19% to 84%, respectively. Multivariate CS analysis revealed that differences in stages II through IV CS based on age, gender, and race decreased over time.


CONCLUSIONS
Five-year melanoma-specific CS estimates improve dramatically over time for survivors with advanced stages of disease. These prognostic data are critical to patients for both treatment and nontreatment related life decisions.
Xing
Yan
Y
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
Chang
George J
GJ
Hu
Chung-Yuan
CY
Askew
Robert L
RL
Ross
Merrick I
MI
Gershenwald
Jeffrey E
JE
Lee
Jeffrey E
JE
Mansfield
Paul F
PF
Lucci
Anthony
A
Cormier
Janice N
JN
D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008545:Melanoma / Q000401:mortality* / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D044469:Racial Groups; D018426:SEER Program; D012737:Sex Factors; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology