title: β-Blocker use and reduced disease progression in patients with thick melanoma: 8 years of follow-up.
abstract: Previous observational studies have reported the protective effect of β-blockers on the progression of different types of cancers. In 2011, we published a prospective study, including patients with histologically confirmed malignant melanoma in stage II-IIIA. In total, 25% of them reported previous use of β-blockers that were administered at any time for any other diseases. After a median follow-up of 2.5 years, 34% of the patients in the untreated group showed disease progression. In contrast, only 3% of the patients in the treated group showed progression. We report the findings obtained in the same cohort after a longer period of β-blocker therapy and follow-up (8 years). We prospectively reviewed data of the patients enrolled in the original prospective study. Disease progression was assessed by evaluating the presence of lymphatic, in-transit or visceral metastases. Deaths by any cause and deaths because of melanoma were recorded. A multivariate Cox proportional hazards model was used to evaluate the effect of β-blocker use on disease-free survival and overall survival, adjusting for significant confounders. After a median follow-up of 8 years and a median duration of β-blocker use of 7.6 years, 45% of the patients in the untreated group and 30% of the patients in the treated group showed disease progression. Notably, in the untreated group 35% patients died from melanoma and only 17% patients died from melanoma in the treated group. Results of this hospital-based prospective cohort study with a median follow-up of 8 years confirmed our previous results that the use of β-blockers significantly reduced the risk of recurrence and mortality in melanoma patients.
authors.affiliation: aDepartment of Dermatology bDepartment of Preclinical and Clinical Pharmacology cDepartment of Geriatric Cardiology and Medicine, University of Florence, University Hospital, Florence dDivision of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Giorgi
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
authors.forename: Sara
authors.initials: S
authors.lastname: Gandini
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D000319:Adrenergic beta-Antagonists