Sharon CE, et al. - Authors assessed the relationship between marital status and T stage at the time of presentation with early-stage melanoma and the decision for sentinel lymph node biopsy (SLNB) in appropriate patients. An association of marital status with earlier presentation of localized melanoma was noted. Also, a less likeliness of undergoing SLNB for appropriate lesions was seen in never married, divorced, and widowed patients. While counseling patients for melanoma procedures and when recommending screening and follow-up, marital status should be considered to optimize patient care.

Methods

• The Surveillance, Epidemiology, and End Results database of 18 population-based registered cancer institutes was used by this retrospective, population-based study.
• For this study, experts identified patients with cutaneous melanoma who were at least 18 years of age and without evidence of regional or distant metastases and presented from January 1, 2010, through December 31, 2014.
• They analyzed the data from September 27 to December 5, 2017.
• Marital status, categorized as married, never married, divorced, or widowed were the main exposures.
• Clinical T stage at presentation and performance of SLNB for lesions with Breslow thickness greater than 1 mm were included as main outcomes and measures.

Results

• As per data, a total of 52,063 patients were identified (58.8% men and 41.2% women; median age, 64 years; interquartile range, 52-75 years).
• Findings suggested that among married patients, 16,603 (45.7%) were presented with T1a disease, compared to 3,253 never married patients (43.0%), 1,422 divorced patients (39.0%), and 1,461 widowed patients (32.2%) (P < .001).
• Conversely, compared with 1,188 married patients (3.3%), 428 widowed patients (9.4%) presented with T4b disease (P < .001).
• Results demonstrated that at presentation the association between marital status and higher T stage remained significant among never married (odds ratio [OR], 1.32; 95% CI, 1.26-1.39; P < .001), divorced (OR, 1.38; 95% CI, 1.30-1.47;P < .001), and widowed (OR, 1.70; 95% CI, 1.60-1.81;P < .001) patients after adjustment for various socioeconomic and patient factors.
• Married patients, independent of T stage and other patient factors were more likely to undergo SLNB in lesions with Breslow thickness greater than 1 mm, for which SLNB was routinely recommended, compared with never married (OR, 0.59; 95% CI, 0.53-0.65;P < .001), divorced (OR, 0.87; 95% CI, 0.76-0.99;P=.03), and widowed (OR, 0.69; 95% CI, 0.62-0.76;P < .001) patients.