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

Bonnie E. Gould Rothberg ^a^,^b^,^c^,^d^,^,,
Kaleigh J. Bulloch ^a^,,
Judith A. Fine ^e^,¹^,,
Raymond L. Barnhill ^f^,,
Marianne Berwick ^g^,^h^,

doi:10.1016/j.canep.2014.08.005

Get rights and content

Highlights

•: 249 patients with localized melanomas ≥1.00 mm thick were followed for 15 years.
•: Smoking, dietary preferences, BMI and alcohol use were measured at diagnosis.
•: After adjustment for tumor thickness, age, lesion location and hair color.
•: Eating red meat at least weekly was associated with poorer survival.
•: Eating fruit at least daily was associated with better survival.

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.

Keywords

Cutaneous melanoma;
Prognosis;
Mortality;
Red meat;
Fruit;
Hair color;
Alcohol use;
Fish;
Smoking;
Body mass index

: Corresponding author at: Yale Cancer Center, Yale School of Medicine, NSB287, 333 Cedar Street, New Haven, CT 06520-8028, US. Tel.: +1 203 737 6313; fax: +1 203 785 4116.

1: Present address: currently retired: 1089, Little Meadow Road, Guilford, CT 06437, USA.

Cheryl & ethnovet

twitter

Sunday, 3 May 2015