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Outcomes for smokers who develop melanoma: a systematic review and meta-analysis
Erica B Friedman1, Gabrielle J Williams2,3, Serigne N Lo2,3
1Department of Surgery, New York University Langone Health, New York, NY, USA.
Eclinicalmedicine
|January 7, 2025
Summary
Current smokers face a 33% higher risk of melanoma death compared to never-smokers. Former smokers have similar survival rates. Smoking also increases risks for sentinel node positivity and surgical complications.
Area of Science:
- Oncology
- Epidemiology
- Public Health
Background:
- Melanoma incidence is lower in smokers, but survival outcomes are less understood.
- Increased risk of melanoma recurrence and death in smokers requires further investigation.
- Magnitude of survival differences in melanoma patients based on smoking status is poorly documented.
Purpose of the Study:
- To systematically review and analyze melanoma survival outcomes in smokers versus never-smokers.
- To quantify the magnitude of survival differences in melanoma patients who smoke.
- To compare risks of melanoma recurrence and death between current smokers, former smokers, and never-smokers.
Main Methods:
- Systematic literature search of Medline, Embase, and Cochrane CENTRAL databases.
- Inclusion of studies reporting melanoma outcomes (disease severity, death risk, treatment effects) in smokers and never-smokers.
- Risk of bias assessment using the Newcastle-Ottawa tool and protocol registration with PROSPERO.
Main Results:
- 46 studies with 164,166 patients analyzed; 70,766 were smokers.
- Current smokers had a 33% higher risk of melanoma death (HR 1.33) compared to never-smokers.
- Former smokers showed similar melanoma death rates to never-smokers (HR 1.04).
- Current smokers had higher risks of sentinel node positivity and complications from node surgery.
Conclusions:
- Current smokers have a significantly increased risk of dying from melanoma.
- Former smokers do not appear to have an elevated risk of melanoma mortality compared to never-smokers.
- Smoking is associated with increased risk of sentinel node positivity and surgical complications in melanoma patients.
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