Surgery vs non-surgery in cutaneous melanoma based on SEER database: A cross-sectional study

Area of Science:

• Oncology
• Surgical Oncology
• Biostatistics

Background:

• Cutaneous melanoma (CM) is a significant public health concern.
• Treatment decisions, particularly surgery, can impact patient survival.
• Robust statistical methods are needed to accurately assess treatment efficacy.

Purpose of the Study:

• To evaluate the survival outcomes of cutaneous melanoma patients who underwent surgery versus those who did not.
• To apply inverse probability of treatment weighting (IPTW) using propensity scores for a more accurate comparison.

Main Methods:

• Utilized the Surveillance, Epidemiology, and End Results (SEER) database to identify 2203 CM patients.
• Employed propensity score analysis and IPTW to adjust for confounding factors between surgery and non-surgery groups.
• Estimated survival outcomes using hazard ratios (HR) and confidence intervals (CI).

Main Results:

• The IPTW-weighted cohort showed a median survival of 130 months for the surgery group versus 75 months for the non-surgery group.
• Surgical treatment was associated with a significantly lower risk of death (HR: 0.423, P < .001) in the weighted cohort.
• Both unmatched and matched cohorts also indicated improved survival with surgery.

Conclusions:

• Surgical intervention is associated with substantially better survival outcomes for cutaneous melanoma patients.
• IPTW using propensity scores provides a reliable method for comparing survival in observational studies.
• These findings support the role of surgery in managing CM and improving patient prognosis.