Survival between synchronous and non-synchronous multiple primary cutaneous melanomas—a SEER database analysis

• Main Authors: Jie Xiong, Yanlin Su, Zhitong Bing, Bihai Zhao
• Format: Article
• Language: English
• Published: PeerJ Inc. 2020-01-01
• Series: PeerJ
• Subjects: Multiple primary cutaneous melanoma (MPM); Synchronous; Non-synchronous; Survival; Surveillance epidemilogy and end results (SEER)
• Online Access: https://peerj.com/articles/8316.pdf

Background There is no criterion to distinguish synchronous and non-synchronous multiple primary cutaneous melanomas (MPMs). This study aimed to distinguish synchronous and non-synchronous MPMs and compare the survivals of them using the Surveillance, Epidemiology, and End Results database. Methods Synchronous and non-synchronous MPMs were distinguished by fitting the double log transformed distribution of the time interval between the first and second primary cutaneous melanomas (TIFtS) through a piecewise linear regression. The overall and melanoma-specific survivals were compared by the Kaplan–Meier method and Cox proportional hazard model through modeling the occurrence of synchronous MPMs as a time-dependent variable. Results The distribution of TIFtS was composed by three power-law distributions. According to its first inflection point, synchronous MPMs were defined as tumors that occurred within 2 months. The Kaplain–Meier plot revealed a significant inferior survival for synchronous MPMs than non-synchronous MPMs (P < 0.0001), and the occurrence of synchronous MPM was a risk factor for overall survival of cutaneous melanoma (CM) (hazard ratio: 2.213; (95% CI [2.087–2.346]); P < 0.0001). Conclusions This study provided data analysis evidences for using 2 months to distinguish synchronous MPMs and non-synchronous MPMs. Furthermore, the occurrence of synchronous MPM was a risk factor for prognosis of patients with CM.