Red meat and fruit intake is prognostic among patients with localized cutaneous melanomas more than 1mm thick

Abstract

Background As the 10-year mortality for localized cutaneous melanoma more than 1.00 mm thick approaches 40% following complete resection, non-therapeutic interventions that can supplement recommended active surveillance are needed. Although guidelines recommending nutrition, physical activity and tobacco cessation for cancer survivors have been published, data describing their associations with melanoma survivorship are lacking. Methods Analysis of modifiable lifestyle behaviors collected on the 249 cases with melanomas more than 1.00 mm thick enrolled in the Connecticut Case-Control Study of Skin Self-Examination study was conducted. Independent associations with melanoma-specific survival were evaluated through Cox proportional hazards modeling adjusting for age, gender, Breslow thickness, ulceration and the presence of microsatellites. Independently significant variables were then combined into a single model and backwards elimination was employed until all remaining variables were significant at p<0.05. Results Following adjustment for age, Breslow thickness and anatomic site of the index melanoma, daily fruit consumption was associated with improved melanoma-specific survival (HR=0.54; 95% CI: 0.34–0.86) whereas at least weekly red meat consumption was associated with worse outcomes (HR=1.84; 95% CI: 1.02–3.30). Natural red (HR=0.44; 95% CI: 0.22–0.88) or blond (HR=0.52; 95% CI: 0.29–0.94) hair were also favorably prognostic. Higher fish consumption was of borderline significance for improved survival only when considered independently (HR=0.65; 95% CI: 0.40–1.05); no association was seen following adjustment for red meat and fruit consumption (p>0.10). Conclusions Dietary choices at the time of diagnosis are associated with melanoma-specific survival in patients with melanomas more than 1.00 mm thick. Further validation of our findings in larger cohorts with repeated post-diagnostic measures is warranted to further evaluate whether dietary modification during the survivorship period can improve melanoma-specific survival.

Vegetable and Fruit Consumption and Prognosis Among Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies

“…The only study in melanoma patients, the Connecticut Skin Self-Examination Case-Control Study, found no association between the daily consumption of fruit or weekly consumption of green salad before diagnosis and site-specific cancer mortality ( 39 ).…”

“…The main cause for this classification was the concern of changes in exposure status among patients. In addition, minor reasons reducing the quality of studies were observed: bias due to confounding ( 40 , 41 , 57 ), bias in classification of exposures ( 39 , 40 , 42 , 47 , 48 , 56 ), and bias in selection of the reported results ( 36 , 39 , 41 , 42 , 57 , 61 ) ( Supplemental Table 7 ). More details about the items considered in both the ROBINS-E and the STROBE-nut scale are provided as supplementary material ( Supplemental Tables 8 and 9 , respectively).…”

No association between smoking and sentinel lymph node metastasis and survival in cutaneous melanoma

“…In one case–control study, Gould Rothberg et al . found no evidence of an association between smoking at the time of melanoma diagnosis and worse 10‐year survival outcomes in 249 patients with melanoma >1 mm.…”

“…9 The aim of this study was to use propensity score matching to determine whether smoking is associated with a higher risk of SLN metastasis or worse prognosis in patients with cutaneous melanoma. Table 1 Characteristics of patients with cutaneous melanoma depending on smoking habit before and after matching based on propensity score (23) 26 (23) 29 (25) 26 (23) 27 (24) 38 (22) 39 (22) Others 15 (13) 96 (21) 27 (16) 15 (13) 19 (17) 15 (13) 13 (12) 29 (17) 27 ( tertiary hospital in Valencia, Spain. We selected consecutive patients whose medical records mentioned smoking status.…”

Research gaps in evaluating the relationship of meat and health

“…A single case-control study from the Unites States has reported significantly elevated RR of 1.84 for cutaneous melanomas associated with red meat intake of more than once weekly compared with less than once a week (Gould Rothberg, Bulloch, Fine, Barnhill, & Berwick, 2014). Other factors identified as significantly associated with melanoma occurrence were age, hair color and fruit consumption; incidence increased with age and decreased with greater fruit intake.…”