Home Health & Wellness Smoking Significantly Increases Melanoma Mortality Risk, Finds New Study

Smoking Significantly Increases Melanoma Mortality Risk, Finds New Study

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A recent cohort study has uncovered a significant correlation between smoking and increased mortality risk in patients with early-stage primary cutaneous melanoma. Dr Katherine M. Jackson and her team’s study, which examined data from two significant international clinical trials, found that current smokers have a significantly higher risk of dying from melanoma than do nonsmokers and former smokers. The findings were published in the journal JAMA Network Open.

The role of smoking in the progression and mortality of various cancers is well-established, but its impact on melanoma has been less clear. Previous research indicated a paradoxically lower incidence of melanoma among smokers, but the relationship between smoking and melanoma-specific survival (MSS) remained ambiguous. This study aimed to clarify this relationship by examining survival outcomes in smokers and non-smokers diagnosed with early-stage melanoma.

The study used information from the first and second Multicenter Selective Lymphadenectomy Trials (MSLT-I and MSLT-II), which included 6,279 melanoma patients between the ages of 18 and 75 in clinical stages I or II. Participants were categorised based on their smoking status: current, former, or never smokers. The median follow-up periods were 110 months for MSLT-I and 67.6 months for MSLT-II.

The study found that current smokers had a significantly higher risk of melanoma-specific death compared to those who never smoked, with a hazard ratio (HR) of 1.48. The increased risk was particularly pronounced among patients with negative sentinel lymph node biopsy (SLNB) findings, where current smokers had an HR of 1.85. This elevated risk was also observed, though to a lesser extent, in patients with positive SLNB findings (HR, 1.29) and those under nodal observation (HR, 1.68).

In contrast, former smokers did not show a significant increase in melanoma-specific mortality risk compared to never smokers, suggesting that the adverse effects of smoking on melanoma progression might be mitigated upon smoking cessation.

The mechanisms by which smoking exacerbates melanoma progression are multifaceted. Smoking has been shown to reduce cutaneous blood flow, induce endothelial injury, and promote a procoagulant state, all of which can facilitate tumour metastasis. Additionally, nicotine and other smoking-related compounds can impair immune responses, potentially allowing melanoma cells to proliferate and spread more rapidly.

The study highlights the importance of smoking cessation, particularly for patients diagnosed with early-stage melanoma. Given the reversibility of some smoking-related damage, quitting smoking may improve survival outcomes for melanoma patients. These findings underscore the need for healthcare providers to strongly advocate for smoking cessation as part of melanoma management.

Dr Jackson and her team suggest that smoking status should be routinely assessed and recorded at the time of melanoma diagnosis. This data could be vital for tailoring treatment strategies and for use as a stratification factor in clinical trials. The inclusion of quantitative smoking data in melanoma databases could enhance our understanding of smoking’s impact on melanoma progression and survival.

Future research should focus on the benefits of smoking cessation post-diagnosis and explore the biological mechanisms through which smoking influences melanoma outcomes. Such studies could lead to the development of targeted interventions to mitigate the risks associated with smoking in melanoma patients.

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