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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.

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    ,

    Yale Cancer Center, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520-8028, USA; Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520-8028, USA; Department of Pathology, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520-8028, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT 06520-8034, USA. Electronic address: bonnie.gouldrothberg@yale.edu.

    ,

    Yale Cancer Center, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520-8028, USA. Electronic address: Kaleigh.bulloch@yale.edu.

    ,

    University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA. Electronic address: judie7168@gmail.com.

    ,

    Department of Pathology and Laboratory Medicine, University of California, Los Angeles School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. Electronic address: rbarnhill@mednet.ucla.edu.

    Department of Internal Medicine, University of New Mexico, MSC 10-5550, 1 University of New Mexico, Albuquerque, NM 87131, USA; Department of Dermatology, University of New Mexico, MSC 10-5550, 1 University of New Mexico, Albuquerque, NM 87131, USA. Electronic address: mberwick@salud.unm.edu.

    Source

    Cancer epidemiology 38:5 2014 Oct pg 599-607

    MeSH

    Aged
    Animals
    Case-Control Studies
    Diet
    Female
    Fishes
    Follow-Up Studies
    Fruit
    Hair Color
    Humans
    Life Style
    Male
    Meat
    Melanoma
    Middle Aged
    Prognosis
    Skin Neoplasms
    Survival Rate

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    25194935

    Citation

    Gould Rothberg, Bonnie E., et al. "Red Meat and Fruit Intake Is Prognostic Among Patients With Localized Cutaneous Melanomas More Than 1mm Thick." Cancer Epidemiology, vol. 38, no. 5, 2014, pp. 599-607.
    Gould Rothberg BE, Bulloch KJ, Fine JA, et al. Red meat and fruit intake is prognostic among patients with localized cutaneous melanomas more than 1mm thick. Cancer Epidemiol. 2014;38(5):599-607.
    Gould Rothberg, B. E., Bulloch, K. J., Fine, J. A., Barnhill, R. L., & Berwick, M. (2014). Red meat and fruit intake is prognostic among patients with localized cutaneous melanomas more than 1mm thick. Cancer Epidemiology, 38(5), pp. 599-607. doi:10.1016/j.canep.2014.08.005.
    Gould Rothberg BE, et al. Red Meat and Fruit Intake Is Prognostic Among Patients With Localized Cutaneous Melanomas More Than 1mm Thick. Cancer Epidemiol. 2014;38(5):599-607. PubMed PMID: 25194935.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Red meat and fruit intake is prognostic among patients with localized cutaneous melanomas more than 1mm thick. AU - Gould Rothberg,Bonnie E, AU - Bulloch,Kaleigh J, AU - Fine,Judith A, AU - Barnhill,Raymond L, AU - Berwick,Marianne, Y1 - 2014/09/05/ PY - 2014/06/09/received PY - 2014/08/12/revised PY - 2014/08/13/accepted PY - 2014/9/8/entrez PY - 2014/9/10/pubmed PY - 2015/6/13/medline KW - Alcohol use KW - Body mass index KW - Cutaneous melanoma KW - Fish KW - Fruit KW - Hair color KW - Mortality KW - Prognosis KW - Red meat KW - Smoking SP - 599 EP - 607 JF - Cancer epidemiology JO - Cancer Epidemiol VL - 38 IS - 5 N2 - 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. SN - 1877-783X UR - https://www.unboundmedicine.com/medline/citation/25194935/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1877-7821(14)00145-3 DB - PRIME DP - Unbound Medicine ER -