β-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 badrenoreceptor inhibition might influence disease progression of melanoma. Patients and methods: Patients P18 years with cutaneous melanoma (Breslow thickness >1 mm) registered 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 b-blockers from PHARMO record linkage system (RLS) matched on age and gender served as a control cohort. Adjusted time-dependent and timefixed Cox proportional hazard models were employed to estimate the hazard ratio of all-cause mortality. Five-year relative survival rates for all-cause mortality were calculated to estimate disease specific survival. Results: 203 of 709 eligible patients used b-blockers after melanoma diagnosis. The use of 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 b-blocker dosage showed significant influence on survival. Five-year relative survival for b-blocker users was lower than in non-users amongst melanoma patients (80.9% and 83.7%, respectively) but higher among the b-blocker control group compared to the general population (101.4%). Conclusion: Our results do not show a statistically significant impact of b-blocker exposure on overall survival of melanoma patients, regardless of the timing, duration or dosage of blocker use.
|Keywords||Betablocker, Melanoma, Noradrenergic signalling pathway, Pharmacoepidemiology, Survival, Time-dependent analysis, Time-fixed analysis, b-Blocker|
|Persistent URL||dx.doi.org/10.1016/j.ejca.2013.07.141, hdl.handle.net/1765/40965|
|Journal||European Journal of Cancer|
Livingstone, E, Hollestein, L.M, van Herk-Sukel, M.P.P, van de Poll-Franse, L.V, Nijsten, T.E.C, Schadendorf, D, & de Vries, E. (2013). β-blocker use and all-cause mortality of melanoma patients: results from a population-based Dutch cohort study. European Journal of Cancer, 49(18), 3863–3871. doi:10.1016/j.ejca.2013.07.141