TY - JOUR
T1 - Impact of Surgical Refusal on Overall Survival in Patients With Melanoma
T2 - A Comprehensive Analysis
AU - Popp, Reed
AU - Savaliya, Bansi P.
AU - Raikot, Swathi R.
AU - Ahmed, Syeda Hoorulain
AU - Shekouhi, Ramin
AU - Bowers, Jade
AU - Popp, Kyle
AU - Sukniam, Kulkaew B.
AU - Kowkabany, Gabrielle
AU - Jimenez, Paola Berrios
AU - Mubarak, Fatima
AU - Ekpeh, Esinam P.
AU - Bansal, Shivam
AU - Sharan, Seema
AU - Manaise, Harsheen K.
AU - Gabriel, Emmanuel M.
N1 - Publisher Copyright:
©2025 The Author(s).
PY - 2025/3
Y1 - 2025/3
N2 - Background/Aim: Surgery is the primary treatment for melanoma, but some patients refuse it, potentially affecting survival. This study examines demographic and clinical factors associated with surgery refusal to inform targeted interventions. Patients and Methods: We conducted a retrospective cohort study using the National Cancer Database (NCDB) to analyze factors linked to surgery refusal in melanoma patients. Demographic, clinical, and treatment characteristics were compared using Pearson Chi-square and Wilcoxon Rank Sum tests. Results: Among 1,048,575 melanoma patients considered for surgery, 605 (0.1%) refused. Those who refused were older (mean age 75.8 years), had more comorbidities, and were more likely to be racial minorities or socioeconomically disadvantaged (p<0.001). Survival analysis showed a lower overall survival rate in the refusal group, with 66.0% alive at follow-up compared to 78.3% in the non-refusal group. Conclusion: Surgery refusal in melanoma patients is associated with advanced age, frailty, and socioeconomic disadvantages, including racial minority status and lower income. Addressing these barriers may improve treatment acceptance and survival outcomes.
AB - Background/Aim: Surgery is the primary treatment for melanoma, but some patients refuse it, potentially affecting survival. This study examines demographic and clinical factors associated with surgery refusal to inform targeted interventions. Patients and Methods: We conducted a retrospective cohort study using the National Cancer Database (NCDB) to analyze factors linked to surgery refusal in melanoma patients. Demographic, clinical, and treatment characteristics were compared using Pearson Chi-square and Wilcoxon Rank Sum tests. Results: Among 1,048,575 melanoma patients considered for surgery, 605 (0.1%) refused. Those who refused were older (mean age 75.8 years), had more comorbidities, and were more likely to be racial minorities or socioeconomically disadvantaged (p<0.001). Survival analysis showed a lower overall survival rate in the refusal group, with 66.0% alive at follow-up compared to 78.3% in the non-refusal group. Conclusion: Surgery refusal in melanoma patients is associated with advanced age, frailty, and socioeconomic disadvantages, including racial minority status and lower income. Addressing these barriers may improve treatment acceptance and survival outcomes.
KW - Melanoma
KW - cancer disparities
KW - cancer survival
KW - melanoma surgery
KW - refusal
UR - https://www.scopus.com/pages/publications/86000171397
U2 - 10.21873/anticanres.17493
DO - 10.21873/anticanres.17493
M3 - Article
AN - SCOPUS:86000171397
SN - 0250-7005
VL - 45
SP - 1063
EP - 1070
JO - Anticancer Research
JF - Anticancer Research
IS - 3
ER -
