Death rates, survival time, and disease progression in high risk and metastatic melanoma: Evidence from the SEER-Medicare linked database.

17544 Background: Clinical research has shown survival times in advanced melanoma to be short. Our objective was to estimate rates of death, length of survival, and disease progression using real-world administrative data from an elderly Medicare population with high risk (stages IIB/C, IIIA/B, IIIC) or metastatic (stage IV) malignant melanoma.,Data were taken from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, which combines clinical information on incident cancer cases in the US between 1991 and 2002 with longitudinal (1991-2005) Medicare claims for patients (pts) aged ≥65 years. Subjects with ≥1 SEER- reported melanoma diagnosis of stage IIB or higher were selected. An index date was defined as the date of the first observed stage IIB or higher diagnosis. Outcomes were evaluated from index date until end of follow-up as defined by death, interruption of benefits coverage (≥6 months [mos]), or database end (12/31/2005). Kaplan-Meier analyses were conducted to evaluate survival time. Disease progression was identified based on a subsequent SEER-reported melanoma diagnosis of a higher stage than reported at index date or a subsequent ICD-9 diagnosis code (197.xx, 198.xx) for secondary metastases.,6,470 subjects met all inclusion criteria. Stage distribution at index date was: IIB/C (37.6%); IIIA/B (45.9%); IIIC (1.4%); IV (15.2%). Median follow-up was 56, 39, 16, and 6 mos for each stage, respectively. Subjects were evenly distributed by age; 61% were male. Death rates were 54%, 70%, 90%, and 95% for stages IIB/C, IIIA/B, IIIC, and IV, respectively. Median survival times were 38, 26, 15, and 6 mos for each stage, respectively. Among pts with stage IIB/C melanoma at index, 21% progressed to a more advanced stage. Disease progression was observed in 29% and 51% of pts in stages IIIA/B and IIIC at index, respectively.,Study findings were consistent with previous clinical research showing a near 100% death rate and median survival time of 6 mos for stage IV metastatic melanoma (MM). Median survival times for high risk disease stages were consistent with prior research. New therapies aimed at prolonging life and lowering progression rates are needed for pts diagnosed with high risk or MM. [Table: see text].