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

BACKGROUND: Results from preclinical and observational studies suggest that beta-adrenoreceptor inhibition might influence disease progression of melanoma. PATIENTS AND METHODS: Patients 18years with cutaneous melanoma (Breslow thickness >1mm) regitered 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 beta-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 werecalculated to estimate disease specific survival. RESULTS: 203 of 709 eligible patients used beta-blockers after melanoma diagnosis. The use of beta-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 beta-blocker dosage showed significant influence on survival. Five-year relative survival for beta-blocker users was lower than in non-users amongst melanoma patients (80.9% and 83.7%, respectively) but higher among the beta-blocker control group compared to the general population (101.4%). CONCLUSION: Our results do not show a statistically significant impact of beta-blocker exposure on overall survival of melanoma patients, regardless of the timing, duration or dosage of beta-blocker use.

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