Impact of Surgical Refusal on Overall Survival in Patients With Melanoma: A Comprehensive Analysis.

IF 1.6 4区医学 Q4 ONCOLOGY

Anticancer research Pub Date : 2025-03-01 DOI:10.21873/anticanres.17493

Reed Popp, Bansi P Savaliya, Swathi R Raikot, Syeda Hoorulain Ahmed, Ramin Shekouhi, Jade Bowers, Kyle Popp, Kulkaew B Sukniam, Gabrielle Kowkabany, Paola Berrios Jimenez, Fatima Mubarak, Esinam P Ekpeh, Shivam Bansal, Seema Sharan, Harsheen K Manaise, Emmanuel M Gabriel

{"title":"Impact of Surgical Refusal on Overall Survival in Patients With Melanoma: A Comprehensive Analysis.","authors":"Reed Popp, Bansi P Savaliya, Swathi R Raikot, Syeda Hoorulain Ahmed, Ramin Shekouhi, Jade Bowers, Kyle Popp, Kulkaew B Sukniam, Gabrielle Kowkabany, Paola Berrios Jimenez, Fatima Mubarak, Esinam P Ekpeh, Shivam Bansal, Seema Sharan, Harsheen K Manaise, Emmanuel M Gabriel","doi":"10.21873/anticanres.17493","DOIUrl":null,"url":null,"abstract":"Background/aim: Surgery is the primary treatment for melanoma, but some patients refuse it, potentially affecting survival. This study examines demographic and clinical factors associated with surgery refusal to inform targeted interventions.Patients and methods: We conducted a retrospective cohort study using the National Cancer Database (NCDB) to analyze factors linked to surgery refusal in melanoma patients. Demographic, clinical, and treatment characteristics were compared using Pearson Chi-square and Wilcoxon Rank Sum tests.Results: Among 1,048,575 melanoma patients considered for surgery, 605 (0.1%) refused. Those who refused were older (mean age 75.8 years), had more comorbidities, and were more likely to be racial minorities or socioeconomically disadvantaged (p<0.001). Survival analysis showed a lower overall survival rate in the refusal group, with 66.0% alive at follow-up compared to 78.3% in the non-refusal group.Conclusion: Surgery refusal in melanoma patients is associated with advanced age, frailty, and socioeconomic disadvantages, including racial minority status and lower income. Addressing these barriers may improve treatment acceptance and survival outcomes.","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":"45 3","pages":"1063-1070"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anticancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/anticanres.17493","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background/aim: Surgery is the primary treatment for melanoma, but some patients refuse it, potentially affecting survival. This study examines demographic and clinical factors associated with surgery refusal to inform targeted interventions.

Patients and methods: We conducted a retrospective cohort study using the National Cancer Database (NCDB) to analyze factors linked to surgery refusal in melanoma patients. Demographic, clinical, and treatment characteristics were compared using Pearson Chi-square and Wilcoxon Rank Sum tests.

Results: Among 1,048,575 melanoma patients considered for surgery, 605 (0.1%) refused. Those who refused were older (mean age 75.8 years), had more comorbidities, and were more likely to be racial minorities or socioeconomically disadvantaged (p<0.001). Survival analysis showed a lower overall survival rate in the refusal group, with 66.0% alive at follow-up compared to 78.3% in the non-refusal group.

Conclusion: Surgery refusal in melanoma patients is associated with advanced age, frailty, and socioeconomic disadvantages, including racial minority status and lower income. Addressing these barriers may improve treatment acceptance and survival outcomes.

查看原文本刊更多论文

手术拒绝对黑色素瘤患者总体生存的影响：一项综合分析。

背景/目的：手术是黑色素瘤的主要治疗方法，但一些患者拒绝手术，这可能会影响患者的生存。本研究探讨了人口统计学和临床因素与手术拒绝告知有针对性的干预措施。患者和方法：我们使用国家癌症数据库（NCDB）进行了一项回顾性队列研究，分析与黑色素瘤患者拒绝手术相关的因素。采用Pearson卡方检验和Wilcoxon秩和检验比较人口学、临床和治疗特征。结果：在1,048,575例考虑手术的黑色素瘤患者中，605例（0.1%）拒绝手术。拒绝手术的患者年龄较大（平均年龄75.8岁），有更多的合并症，并且更有可能是少数种族或社会经济弱势群体（结论：黑色素瘤患者拒绝手术与高龄、虚弱和社会经济劣势相关，包括少数种族地位和低收入）。解决这些障碍可能会提高治疗的接受度和生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.