Smoking is an Independent Marker of Poor Prognosis in Cutaneous Melanoma

Previous studies have suggested that persistent tobac-co smoking impairs survival in cutaneous melanoma, but the effects of smoking and other prognostic fac-tors have not been described in detail. This study exa-mined the association of smoking (persistent, former, or never) with melanoma-specific (MSS) and overall survival (OS) in patients with cutaneous melanoma treated in Southwest Finland during 2005 to 2019. Clinical characteristics were obtained from electro-nic health records for 1,980 patients. Smoking status was available for 1,359 patients. Patients were resta-ged according to the 8th edition of the tumour-node -metastasis (TNM) classification. Smoking remained an independent prognostic factor for inferior melanoma -specific survival regardless of age, sex, stage, and co -morbidities. The hazard ratio of death from melanoma was 1.81 (1.27-2.58, p = 0.001) in persistent and 1.75 (1.28-2.40, p = 0.001) in former smokers compared with never smokers. In 351 stage IV patients, smoking was associated with increased melanoma-specific and overall mortality: median MSS 10.4 (6.5-14.3), 14.6 (9.1-20.1), and 14.9 (11.4-18.4) months, p = 0.01 and median OS 10.4 (6.5-14.3), 13.9 (8.6-19.2), and 14.9 (11.7-18.1) months, p = 0.01 in persistent, for-mer, and never smokers, respectively. In conclusion, since smoking represents an independent modifiable poor prognostic factor in patients with cutaneous me-lanoma, smoking habits should be proactively asked about by healthcare professionals, in order to support smoking cessation.SIGNIFICANCEEarlier studies have suggested that smoking impairs sur-vival in patients with cutaneous melanoma, but the effect of smoking, along with other established prognostic fac-tors, has not been described in detail. This study examined the association of smoking status (persistent, former, or never) with survival in patients with cutaneous melanoma treated in Southwest Finland in 2005 to 2019. Smoking was an independent prognostic factor for shorter survival after adjustment for other risk factors, including age, sex, TNM stage, and comorbidities. The detrimental effect of smoking on survival was most marked in patients with me-tastatic melanoma and these patients should routinely be supported to stop smoking.

Automated summary

Previous studies have shown that persistent tobacco smoking is associated with lower survival rates in patients with cutaneous melanoma, but the effects of smoking and other prognostic factors have not been extensively studied. This study examined the relationship between smoking (persistent, former, or never) and melanoma-specific (MSS) and overall survival (OS) in patients with cutaneous melanoma treated in Southwest Finland from 2005 to 2019. The results showed that smoking remained an independent prognostic factor for inferior melanoma-specific survival, regardless of age, sex, stage, and comorbidities. The study also found that smoking was associated with increased melanoma-specific and overall mortality in stage IV patients. Therefore, healthcare professionals should actively inquire about smoking habits in order to support smoking cessation.