Long-term outcomes of stage IIB-IV melanoma patients: nationwide data from Norway

Future Oncol. 2023 Jan;19(3):205-215. doi: 10.2217/fon-2022-0969. Epub 2023 Mar 28.


Aim: This study was performed to investigate the characteristics and overall survival (OS) of patients with completely resected stage IIB-IV cutaneous melanoma identified in the Cancer Registry of Norway. Methods: A retrospective cohort study of all adult patients with stage ≥IIB cutaneous melanoma was performed in Norway (January 2008 to December 2018), excluding patients with stage IV melanoma without evidence of surgery. Results: 5-year OS varied by stage (IIB 65%, IIC 38%, IIIA 79%, IIIB 66%, IIIC 52%, IIID 37% and IV 39%). Adjusted Cox models showed that stage IIIA and IIIB patients showed similar survival to stage IIB patients (hazard ratio [95% CI]: IIIA 0.67 [0.44-1.04]; IIIB 1.18 [0.96-1.45]), while all other stages had lower survival than IIB. Conclusion: Survival for stage II patients, particularly IIC, can be poor and in some cases worse than patients with more advanced stage melanoma. Our data highlight an unmet need for effective adjuvant treatment options among stage IIB/C patients.

Keywords: Norwegian Melanoma Registry; The Cancer Registry of Norway; cutaneous melanoma; mortality; survival.

Plain language summary

The number of people diagnosed with skin cancer cutaneous melanoma is increasing globally, with Norway having the second highest rate of death due to melanoma in the world. The stage of disease (how much the tumor has spread) determines which treatment is most effective. While early-stage disease is typically considered of low risk, people diagnosed at this stage have a high risk of disease recurrence and a similar chance of survival to those diagnosed at a later disease stage. By researching how long people with melanoma survive based on their disease stage, we gain greater insight into which groups of patients may have an unmet need for therapy. This study aimed to understand how long patients with melanoma in Norway survive after diagnosis, based on their disease stage at diagnosis. The study used patient data from the Cancer Registry of Norway and included only the patients diagnosed with at least stage IIB melanoma from January 2008 to December 2018, unless they had stage IV disease that had not been treated with surgery. This study found that the proportion of patients who survived to 5 years was dependent on the disease stage at diagnosis; however, patients in earlier stages had similar survival to those in later (although not very late) stages of disease. This research shows that patients diagnosed with early-stage melanoma in Norway have an unmet need for treatment options following surgery that address the severity of their risk. This research may help inform decision-making around which treatments patients with early-stage melanoma have access to.

MeSH terms

  • Adult
  • Humans
  • Melanoma* / epidemiology
  • Melanoma* / therapy
  • Neoplasm Staging
  • Retrospective Studies
  • Skin Neoplasms* / epidemiology
  • Skin Neoplasms* / surgery

Supplementary concepts

  • Melanoma, Cutaneous Malignant