β-Blocker use and all-cause mortality of melanoma patients: Results from a population-based Dutch cohort study

• Published in: European journal of cancer (1990) 2013-12, Vol.49 (18), p.3863-3871
• Main Authors: Livingstone, E, Hollestein, L.M, van Herk-Sukel, M.P.P, van de Poll-Franse, L, Nijsten, T, Schadendorf, D, de Vries, E
• Format: Article
• Language: English
• Subjects: Adrenergic beta-Antagonists - classification; Adrenergic beta-Antagonists - therapeutic use; Aged; Betablocker; Biological and medical sciences; Cause of Death; Cohort Studies; Female; Hematology, Oncology and Palliative Medicine; Humans; Male; Medical sciences; Melanoma; Melanoma - drug therapy; Melanoma - mortality; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Netherlands; Noradrenergic signalling pathway; Outcome Assessment (Health Care) - statistics & numerical data; Pharmacoepidemiology; Pharmacology. Drug treatments; Proportional Hazards Models; Registries - statistics & numerical data; Skin Neoplasms - drug therapy; Skin Neoplasms - mortality; Survival; Survival Analysis; Survival Rate; Time-dependent analysis; Time-fixed analysis; Tumors; β-Blocker
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2013.07.141

Abstract Background Results from preclinical and observational studies suggest that β-adrenoreceptor inhibition might influence disease progression of melanoma. Patients and methods Patients ⩾18 years with cutaneous melanoma (Breslow thickness >1 mm) registered in the Eindhoven Cancer Registry between January 1, 1998 and December 31, 2010, who were also registered with PHARMO record linkage system (RLS), were eligible. Randomly selected patients using β-blockers from PHARMO record linkage system (RLS) matched on age and gender served as a control cohort. Adjusted time-dependent and time-fixed Cox proportional hazard models were employed to estimate the hazard ratio of all-cause mortality. Five-year relative survival rates for all-cause mortality were calculated to estimate disease specific survival. Results 203 of 709 eligible patients used β-blockers after melanoma diagnosis. The use of β-blockers was not associated with the risk of dying (adjusted hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.55–1.24). Neither duration of exposure nor β-blocker dosage showed significant influence on survival. Five-year relative survival for β-blocker users was lower than in non-users amongst melanoma patients (80.9% and 83.7%, respectively) but higher among the β-blocker control group compared to the general population (101.4%). Conclusion Our results do not show a statistically significant impact of β-blocker exposure on overall survival of melanoma patients, regardless of the timing, duration or dosage of β-blocker use.