Systematic review and meta-analysis of outcomes of melanoma among smokers

There is compelling evidence that the incidence of melanoma among cigarette smokers is substantially lower than among non-smokers. However, the magnitude of risks of both recurrence and death of smokers who develop melanoma is not clear. A systematic review and meta-analysis of 46 studies, involving 164,166 melanoma patients, found that death from melanoma was 33% higher in current compared to never-smokers (HR 1.33; p=0.0002) whereas former-smokers and never-smokers had very similar rates of death from melanoma (HR 1.04; p=0.52). Current smokers had a higher risk of sentinel node-positivity compared to never-smokers (HR 1.35; p=0.001). Ever-smokers had a greater risk of complications from sentinel node biopsy (OR 2.0; p=0.0001) and lymph node dissection (OR 1.7; p=0.0007) than never-smokers. The authors conclude that current smokers are more likely to die from their melanoma than never-smokers, while former smokers appear to have similar risks to never-smokers.