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Amelanotic Melanoma Tied to Worse Survival
TOPLINE:
Patients with amelanotic melanoma showed poorer disease-specific survival (DSS) than those with melanotic melanoma in a Surveillance, Epidemiology, and End Results (SEER) database analysis.
METHODOLOGY:
Researchers analyzed data on patients with invasive cutaneous amelanotic melanoma (n = 1598) and melanotic melanoma (n = 417,974) from the SEER 17 database between 2000 and 2021.
Patients with amelanotic melanoma were older at diagnosis and presented with more advanced-stage disease than those with melanotic melanoma (regional/distant stages: 26.8% vs 12.4%), ulceration (35.6% vs 13.1%), and Breslow thickness > 2 mm (42% vs 17%).
The primary outcome was DSS.
TAKEAWAY:
Five-year DSS was significantly lower in patients with amelanotic melanoma (78.6%) than in those with melanotic melanoma (91.3%; P < .001).
Patients with amelanotic melanoma carried a 31% higher risk for mortality after adjusting for sex, age, and stage (P < .001).
Among those with amelanotic melanoma, men (hazard ratio [HR], 1.38; P = .014 vs women) had a higher disease-specific mortality, and mortality was higher among adults aged 85 years and older (HR, 1.86; P = .002 vs patients aged 45-64 years).
Amelanotic melanoma diagnoses made 2011 onward were associated with a lower mortality risk (HR, 0.55; P < .001) than those diagnosed before 2011, with 2-year DSS for distant metastases more than doubling from 26.4% during 2000-2005 to 58.8% during 2016-2021.
IN PRACTICE:
'This study underscores the poorer survival outcomes associated with AM [amelanotic melanoma] compared to MM [melanotic melanoma] and highlights a potential survival improvement following the availability of immunotherapy,' the study authors wrote. They called for prospective trials 'to validate these findings and guide tailored management strategies for AM.'
SOURCE:
The study was led by Trang M. Nguyen, MD, National Hospital of Dermatology and Venereology, Hanoi, Vietnam, and was published online on June 12 in Journal of the American Academy of Dermatology.
LIMITATIONS:
Limitations included selection bias and limited follow-up for recent cases.
DISCLOSURES:
The authors reported having no funding sources or relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
