Melanoma Mortality Linked to Serum C-Reactive Protein Levels Among Older Adults

A strong relationship between baseline serum C-reactive protein (CRP) level and mortality risk at 1, 3, and 5 years among older adults with melanoma may suggest that high baseline CRP levels at melanoma diagnosis may indicate a poor prognosis, according to study findings presented at the 2023 Annual Meeting of the American Academy of Dermatology (AAD), held from March 17 to 21, 2023 in New Orleans, Louisiana.

According to the investigators, “There remains a need to identify biomarkers in melanoma patients that are associated with prognosis and can aid in selecting adjunct therapies.” Serum CRP has been identified as being a biomarker of interest that may be associated with prognosis among patients with melanoma. Therefore, the investigators conducted a retrospective cohort study to assess the relationship between serum CRP levels and mortality in this patient population.

Investigators used the TriNetX database that included 1004 de-identified patients at least 50 years of age with documentation of elevated CRP levels (>10 mg/L) within 1 month prior to an initial melanoma diagnosis from 2006 to 2017. A propensity score matched (1:1) cohort (n=1004) with serum CRP levels below 10 mg/L within 1 month prior to an initial melanoma diagnosis was also established. Adjusted hazard ratios (aHR) were calculated for mortality risk, adjusting for comorbidities and demographic information in propensity score matched analyses, and the Cox proportional hazard model was used to estimate aHR. Survival probability in the 5-year follow-up was also estimated with Kaplan-Meier analysis.

Investigators reported a statistically significant increase in mortality at 1-year (aHR, 3.03; 95% CI, 2.37-3.86), 3-year (aHR, 2.42; 95% CI, 2.00-2.92), and 5-year (aHR, 2.15; 95% CI, 1.82-2.53) follow-up among patients with elevated serum CRP levels within 1 month prior to an initial melanoma diagnosis compared with patients with CRP values in the normal range CRP (<10 mg/L).

Study limitations include the design nature of retrospective study, and including only patients at least 50 years of age may leave results not generalizable to the entire adult population.

“There is a strong relationship between initial serum CRP level and mortality among adult patients with melanoma, indicating that high baseline CRP levels at time of melanoma diagnosis could be indicative of a poor prognosis,” investigators concluded. They wrote “Further research examining the role of CRP in melanoma is needed such as specific CRP cutoffs for worse prognosis and examining the impact of CRP levels in conjunction with certain drug therapies in overall survival.”