title: Effect of β-blockers and other antihypertensive drugs on the risk of melanoma recurrence and death.
abstract: OBJECTIVE
  To verify preliminary studies on patients with melanoma exposed to β-blockers that suggested a reduced risk of disease recurrence and death.
  
  
  METHODS
  Data were obtained from all consecutive patients diagnosed as having melanoma between January 1, 1993, and December 31, 2009, at the Department of Dermatology of the University of Florence, Azienda Sanitaria di Firenze. Participants were excluded if at baseline they reported a previous diagnosis of cutaneous malignant melanoma or another malignant disease. We also excluded participants with evidence of visceral, lymph nodal, and in-transit metastasis at the time of the diagnosis.
  
  
  RESULTS
  Of 741 consecutive patients with melanoma, 79 (11%) were prescribed β-blockers (for hypertension in most cases) for 1 or more years (treated) and 662 (89%) were not (untreated). The multivariate Cox model indicated that the treated group had improved overall survival after a median follow-up of 4 years (P=.005). For each year of β-blocker use, the risk of death was reduced by 38%. The presence of hypertension, the use of antihypertensive agents for 1 or more years, or the use of other commonly used medicines were not associated with a better outcome for patients with melanoma.
  
  
  CONCLUSIONS
  The results confirm and strengthen previous findings that β-blocker use is associated with a reduced risk of melanoma recurrence and death. The results also indicate the strong need for a randomized clinical trial to conclusively assess whether β-blockers afford protection against melanoma recurrence and death.
authors.affiliation: Department of Dermatology, University of Florence, Florence, Italy. Electronic address: vincenzo.degiorgi@unifi.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Giorgi
authors.forename: Sara
authors.initials: S
authors.lastname: Gandini
authors.forename: Marta
authors.initials: M
authors.lastname: Grazzini
authors.forename: Silvia
authors.initials: S
authors.lastname: Benemei
authors.forename: Niccolò
authors.initials: N
authors.lastname: Marchionni
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Geppetti
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007558:Italy; D008297:Male; D008545:Melanoma / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors; D012878:Skin Neoplasms; D016019:Survival Analysis; D000096142:Cutaneous Malignant Melanoma
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents
keywords: ACEI; ARB; CMM; DFS; HR; OS; angiotensin receptor blocker; angiotensin-converting enzyme inhibitor; cutaneous malignant melanoma; disease-free survival; hazard ratio; overall survival