Risk factors for cardiovascular mortality and melanoma-specific mortality among patients with melanoma: a SEER based study

Elshanbary, Alaa Ahmed; Zaazouee, Mohamed Sayed; Abdelmonem, Mohamed; Mohammed, Yasmine Adel; Abdel-Aziz, Walid

doi:10.1097/cej.0000000000000690

Cited by 8 publications

(5 citation statements)

References 49 publications

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“…Furthermore, we used the CRM to evaluate the risks of diverse causes of death, calculate cumulative mortality and plot cumulative mortality curves [29]. Our findings are partially similar to those of a previous SEER-based study that showed that among MM patients diagnosed at different ages, patients diagnosed at age 65 and older had the highest CVD mortality [13]. However, that study only analyzed the overall risk of death in older MM patients.…”

Section: Discussionsupporting

confidence: 80%

“…MM itself increases the risk of death from CVD. One study reported that the risk of CVD death in MM patients older than 65 was 43.309-fold higher than that in patients less than 50 years old [13], which further indicates that attention should be paid to the risk of CVD death in older MM patients. However, there have been few reports of an increased risk of CVD death in this population.…”

Section: Introductionmentioning

confidence: 99%

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Risk of Cardiovascular Disease Death in Older Malignant Melanoma Patients: A Population-Based Study

Miao

Wang

et al. 2022

Cancers

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Noncancer deaths account for a large proportion of deaths in patients with malignant melanoma (MM), but the risk of cardiovascular disease (CVD) death in older MM patients remains unclear. This study aimed to estimate the risk of CVD death in older MM patients. Data on older MM patients were obtained in the Surveillance, Epidemiology, and End Results database. Risk of CVD death was calculated by standardized mortality rates (SMRs), cumulative mortality and proportion of different causes of death. MM patients had a higher risk of CVD death than general populations (SMR = 1.98; 95% CI 1.93–2.03, p < 0.001). CVD death was more common in MM patients who were diagnosed at age 85 or older, had a localized stage, were white, had surgical treatment, had a primary head/neck/upper limb site and had a low-grade and superficial spreading/lentigo malignant pathologic type. Cumulative CVD mortality was more common than primary cancer in all older age groups, male or female, and patients with localized-stage disease. Other than primary cancer, CVD was the main cause of death in older patients diagnosed with MM. Our findings highlight CVD death is an important competing event of deaths in older MM patients, and more attention should be paid to reducing CVD death to improve survival.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Risk of Cardiovascular Disease Death in Older Malignant Melanoma Patients: A Population-Based Study

Miao

Wang

et al. 2022

Cancers

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“…However, these studies examined heterogeneous cancer populations with variable exposures to other cardiotoxic chemotherapeutics and systemic agents. Nevertheless, from the population-based Surveillance, Epidemiology and End Results registry, melanoma survivors were at increased risk of long-term cardiovascular mortality, particularly those with regional and distant disease [12].…”

Section: Introductionmentioning

confidence: 99%

Immune checkpoint inhibitors and the risk of major atherosclerotic cardiovascular events in patients with high-risk or advanced melanoma: a retrospective cohort study

et al. 2022

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Background Immune checkpoint inhibitors (ICI) are associated with immune-mediated adverse effects, potentially involving any organ. ICI has also been associated with an increased risk of cardiovascular disease in cancer populations. Objective To characterize the incidence and risk of major atherosclerotic cardiovascular events associated with ICI use in a high-risk and advanced melanoma population. Methods We conducted a retrospective cohort study of patients with high-risk or advanced melanoma (AJCC stage II, III or IV) presenting to an academic tertiary hospital between 2015–2020. The main outcome was major atherosclerotic cardiovascular events (MACE) including acute myocardial infarction, ischemic stroke, acute limb ischemia and coronary revascularization. Results The study cohort consisted of 646 patients, including 289 who had been treated with ICI. The incidence of MACE was higher in the ICI treated group (3.6 vs. 0.9 events per 100-person years). After adjusting for age, sex, smoking history and prior BRAF and/or MEK inhibitor use, ICI treatment was associated with an increased risk of MACE (HRadj 2.8, 95% CI 1.1–6.9, p = 0.03). Elevated risk was especially pronounced in patients with a past history of MACE (HR 14.4, 95% CI 1.9–112.3, p = 0.01). Conclusion Patients with high-risk or advanced melanoma are at an increased risk of atherosclerotic cardiovascular events following ICI treatment, particularly those with a history of cardiovascular disease.

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“…This might be due to the lack of detailed information on chemotherapy and radiotherapy in the SEER database, which may have skewed the results. [ 57 , 58 ] It highlighted the need to enhance the prevention of cardiovascular events in patients with HCC, both before and after surgery. A multifactorial competing risk analysis showed that patients with early-stage HCC (stage I/II cancer differentiation, tumor size ≤ 2 cm, SEER stage localized had a higher risk of CVD compared to patients with advanced HCC.…”

Section: Discussionmentioning

confidence: 99%

Analysis of competing risks of cardiovascular death in patients with hepatocellular carcinoma: A population-based study

Cao,

Wang,

Yan

et al. 2023

Medicine

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Clinical data has shown that cardiovascular diseases (CVDs) have emerged as a prominent cause of mortality in individuals with hepatocellular carcinoma (HCC). This research aimed to reveal the comorbid effects of CVDs in patients with HCC. The cardiovascular mortality of patients diagnosed with HCC between 2000 and 2014 was compared to that of the general US population. Standardized mortality ratios were calculated to quantify the relative risk of cardiovascular mortality in HCC patients. The cumulative incidence of cardiovascular death (CVD) was estimated using Fine-Gray testing, and independent risk factors for CVD were determined using competing risk models. The results were analyzed using the Kaplan–Meier analysis. The overall SMR for CVD in HCC patients was 11.15 (95% CI: 10.99–11.32). The risk of CVD was significantly higher in patients aged < 55 years (SMR: 56.19 [95% CI: 54.97–57.44]) compared to those aged ≥ 75 years (SMR: 1.86 [95% CI: 1.75–1.97]). This study suggests that patients with HCC are at significant risk of developing CVD. Competing risk analyses indicated that age, grade, tumor size, surveillance, epidemiology, and end results stage, and surgical status were independent risk factors for CVD in patients with HCC. Therefore, patients with HCC require enhanced preventive screening and management of CVDs during and after treatment to improve patient survival.

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Risk factors for cardiovascular mortality and melanoma-specific mortality among patients with melanoma: a SEER based study

Cited by 8 publications

References 49 publications

Risk of Cardiovascular Disease Death in Older Malignant Melanoma Patients: A Population-Based Study

Risk of Cardiovascular Disease Death in Older Malignant Melanoma Patients: A Population-Based Study

Immune checkpoint inhibitors and the risk of major atherosclerotic cardiovascular events in patients with high-risk or advanced melanoma: a retrospective cohort study

Analysis of competing risks of cardiovascular death in patients with hepatocellular carcinoma: A population-based study

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