β-Blocker use and all-cause mortality of melanoma patients: results from a population-based Dutch cohort study.
BACKGROUND
Results from preclinical and observational studies suggest that β-adrenoreceptor inhibition might influence disease progression of melanoma.


METHODS
Patients ⩾18years with cutaneous melanoma (Breslow thickness >1mm) registered in the Eindhoven Cancer Registry between January 1, 1998 and December 31, 2010, who were also registered with PHARMO record linkage system (RLS), were eligible. Randomly selected patients using β-blockers from PHARMO record linkage system (RLS) matched on age and gender served as a control cohort. Adjusted time-dependent and time-fixed Cox proportional hazard models were employed to estimate the hazard ratio of all-cause mortality. Five-year relative survival rates for all-cause mortality were calculated to estimate disease specific survival.


RESULTS
203 of 709 eligible patients used β-blockers after melanoma diagnosis. The use of β-blockers was not associated with the risk of dying (adjusted hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.55-1.24). Neither duration of exposure nor β-blocker dosage showed significant influence on survival. Five-year relative survival for β-blocker users was lower than in non-users amongst melanoma patients (80.9% and 83.7%, respectively) but higher among the β-blocker control group compared to the general population (101.4%).


CONCLUSIONS
Our results do not show a statistically significant impact of β-blocker exposure on overall survival of melanoma patients, regardless of the timing, duration or dosage of β-blocker use.
Department of Dermatology, University Hospital Duisburg-Essen, Essen, Germany.
E
E
Livingstone
L M
LM
Hollestein
M P P
MP
van Herk-Sukel
L
L
van de Poll-Franse
T
T
Nijsten
D
D
Schadendorf
E
E
de Vries
D000319:Adrenergic beta-Antagonists / Q000145:classification / Q000627:therapeutic use*; D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016019:Survival Analysis; D015996:Survival Rate
D000319:Adrenergic beta-Antagonists
Betablocker; Melanoma; Noradrenergic signalling pathway; Pharmacoepidemiology; Survival; Time-dependent analysis; Time-fixed analysis; β-Blocker