Trend in survival of patients with advanced melanoma in The Netherlands, 2013 to 2021

A study in The Netherlands investigated the trend in survival of patients with a diagnosis of advanced melanoma between 2013 and 2020. The study included 6260 systemically treated advanced melanoma patients. During the study period, there was an increase of age at diagnosis, percentage of patients with an ECOG performance status 2 or higher, percentage of patients with brain metastasis, and percentage of patients with synchronous diagnosis of primary and unresectable melanoma. The median overall survival increased from 11.2 months (95% CI 10.0-12.4) for patients diagnosed in 2013 to 32.0 months (26.6-36.7) for patients diagnosed in 2019, but subsequently decreased to 26.6 months (23.9-35.1) for patients diagnosed in 2020 and to 24.0 months (20.4-NR) for patients diagnosed in 2021. The trend of worse survival in 2020- and 2021-patients remained significant after correction for known prognostic factors and previous neoadjuvant or adjuvant treatments. The authors conclude that this trend is explained by unmeasured factors.