Melanoma Survival Is Tied to Comorbidity Burden, Illuminating Care Opportunities

A recent observational study reports the significant effect of comorbidity patterns on survival in patients with cutaneous melanoma (CM), underscoring the importance of a comprehensive approach to cancer care.¹

Among more than 2000 patients with CM, approximately half (49.6%) had at least 1 documented comorbidity, with 19.9% having multiple conditions (range, 0-9). The comorbidities observed fell into 3 core categories: cardiovascular, endocrine, and respiratory conditions (20.96%); pregnancy-related and psychosocial conditions (29.97%); and injuries, multiorgan, and multifactorial disorders (49.08%).

Furthermore, multivariate-adjusted Cox regression models revealed that patients with injury-multiorgan-multifactorial conditions had a nearly 3-fold overall mortality risk (HR, 3.08; 95% CI, 2.25-4.22) compared with patients without comorbidities. This group had significantly poorer survival outcomes than those with cardio-endocrine-respiratory conditions (HR, 2.78; 95% CI, 1.89-4.10) and pregnancy-psychosocial conditions (HR, 2.67; 95% CI, 1.67-4.29) (all P < .001). All 3 comorbidity categories were associated with greater melanoma-specific mortality risk (HR range, 1.64-2.79) and were statistically significant at the P < .05 level.

These figures collectively point to the prognostic value of the comorbidity profile, highlighting the overarching need to consider the patient’s overall health status beyond solely tumor characteristics.

“The incorporation of the comorbidity profile into clinical care strategies can improve prognostic accuracy and enhance patient management,” Buja et al wrote in BMC Cancer.¹

Comorbidities in Cancer Care: A Growing Challenge

Comorbidities are common in patients with cancer, and their prevalence in the population has risen over the past few decades, with one study showing an increase of 0.54% per year between 1990 and 2020.² With profound implications for patient outcomes through their impact on diagnosis timing, treatment selection, treatment uptake, and overall quality of life,³ addressing comorbidities throughout cancer care is crucial.

Given the heterogeneity in both number and type of comorbidities observed in this study’s patient cohort, the authors call for a greater “critical reappraisal” of comorbidity patterns, which can help inform outcome prediction. They suggest that better characterizing these patterns could allow for better risk stratification of patients, “potentially resulting in tailoring therapeutic strategies according to the health status of patients [with cancer].”¹

Integrating comorbidity management into concurrent cancer care may also be logistically challenging. To this end, the authors also advocate for greater multidisciplinary collaboration among primary care providers, oncologists, and other specialists to improve care delivery.

Data Source and Limitations

The study sourced case data from the population-based Regional Cancer Registry of Italy's Veneto region, inclusive of pathology reports, clinical charts, death certificates, and public health administrative records. The retrospective analysis included 2114 patients diagnosed with CM in 2019 and 2021.

Comorbidity data were obtained from hospital records and based on International Classification of Diseases, Ninth Revision, Clinical Modification classification. A limitation of this data source, according to the authors, was that milder conditions possibly managed in the outpatient setting may not have been captured in the hospital data. The authors suggested that using administrative records to identify comorbidities may help mitigate this limitation and refine the comorbidity patterns identified in this study.

REFERENCES

1. Buja A, Cassalia F, Rugge M, et al. Impact of comorbidities on survival in melanoma patients. BMC Cancer. Published online November 25, 2025. doi:10.1186/s12885-025-15376-2

2. Vrinzen CEJ, Delfgou L, Stadhouders N, et al. A systematic review and multilevel regression analysis reveals the comorbidity prevalence in cancer. Cancer Res. 2023;83(7):1147-1157. doi:10.1158/0008-5472.CAN-22-1336

3. Schubel LC, Barac A, Magee M, et al. Comorbidities And Reducing InEquitieS (CARES): feasibility of self-monitoring and community health worker support in management of comorbidities among Black breast and prostate cancer patients. Contemp Clin Trials Commun. 2025;43:101387. doi:10.1016/j.conctc.2024.101387