Prognostic impact of socioeconomic status among patients with malignant melanoma of the skin: a population-based study.

Objective

To assess the prognostic impact of socioeconomic status (SES) on the outcome of cases with cutaneous melanoma.

Methods

Novel SEER socioeconomic database has been accessed and patients with malignant melanoma of the skin (2000-2015) were reviewed. SES was evaluated through a specialized multi-dimension index and patients were classified into three groups (group 1/2/3) where group 1 has the lowest SES and group 3 has the highest SES. Kaplan-Meier survival estimates were used to evaluate the impact of SES on overall survival and multivariable Cox regression analysis was used to assess the impact of SES on melanoma-specific survival.

Results

A total of 261,076 patients with malignant melanoma of the skin were included in the current study. Among which, 44,804 patients were within group 1 SES, 84,168 patients were within group 2 SES and 132,104 patients were within group 3 SES. Kaplan-Meier survival analysis was performed, and it showed that patients with lower SES have worse overall survival (p < .001). Multivariable Cox regression analysis was subsequently performed, and it showed also that lower SES is associated with worse melanoma-specific survival (hazard ratio for group 1 versus group 3 SES: 1.361; 95% CI: 1.315-1.409; p < .001).

Conclusion

Patients with cutaneous melanoma and lower SES have worse overall and melanoma-specific survival compared to patients with higher SES. This finding was consistent among different clinical subsets of patients according to stage, race/ethnicity, and year of diagnosis.