title: Conditional survival estimates improve over time for patients with advanced melanoma: results from a population-based analysis.
abstract: 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.
authors.affiliation: Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xing
authors.forename: George J
authors.initials: GJ
authors.lastname: Chang
authors.forename: Chung-Yuan
authors.initials: CY
authors.lastname: Hu
authors.forename: Robert L
authors.initials: RL
authors.lastname: Askew
authors.forename: Merrick I
authors.initials: MI
authors.lastname: Ross
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Gershenwald
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Lee
authors.forename: Paul F
authors.initials: PF
authors.lastname: Mansfield
authors.forename: Anthony
authors.initials: A
authors.lastname: Lucci
authors.forename: Janice N
authors.initials: JN
authors.lastname: Cormier
mesh_terms: 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