Smoking is an Independent Marker of Poor Prognosis in Cutaneous Melanoma


  • Kalle Mattila Department of Oncology and FICAN West Cancer Centre, Turku University Hospital and University of Turku, Turku, Finland; InFLAMES Research Flagship Center, University of Turku, Turku, Finland
  • Helmi Vihinen Turku School of Economics, University of Turku, Turku, Finland
  • Antti Karlsson Auria Biobank and Turku University Hospital, Turku Finland
  • Heikki Minn Department of Oncology and FICAN West Cancer Centre, Turku University Hospital and University of Turku, Turku, Finland
  • Pia Vihinen Department of Oncology and FICAN West Cancer Centre, Turku University Hospital and University of Turku, Turku, Finland
  • Eetu Heervä Department of Oncology and FICAN West Cancer Centre, Turku University Hospital and University of Turku, Turku, Finland



cigarette, melanoma, metastasis, skin cancer, smoking, survival


Previous studies have suggested that persistent tobacco smoking impairs survival in cutaneous melanoma, but the effects of smoking and other prognostic factors have not been described in detail. This study examined the association of smoking (persistent, former, or never) with melanoma-specific (MSS) and overall survival (OS) in patients with cutaneous melanoma treated in Southwest Finland during 2005 to 2019. Clinical characteristics were obtained from electronic health records for 1,980 patients. Smoking status was available for 1,359 patients. Patients were restaged according to the 8th edition of the tumour-node-metastasis (TNM) classification. Smoking remained an independent prognostic factor for inferior melanoma-specific survival regardless of age, sex, stage, and comorbidities. The hazard ratio of death from melanoma was 1.81 (1.27−2.58, p = 0.001) in persistent and 1.75 (1.28−2.40, p = 0.001) in former smokers compared with never smokers. In 351 stage IV patients, smoking was associated with increased melanoma-specific and overall mortality: median MSS 10.4 (6.5−14.3), 14.6 (9.1−20.1), and 14.9 (11.4−18.4) months, p = 0.01 and median OS 10.4 (6.5−14.3), 13.9 (8.6−19.2), and 14.9 (11.7−18.1) months, p = 0.01 in persistent, former, and never smokers, respectively. In conclusion, since smoking represents an independent modifiable poor prognostic factor in patients with cutaneous melanoma, smoking habits should be proactively asked about by healthcare professionals, in order to support smoking cessation.


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How to Cite

Mattila, K., Vihinen, H., Karlsson, A., Minn, H., Vihinen, P., & Heervä, E. (2023). Smoking is an Independent Marker of Poor Prognosis in Cutaneous Melanoma. Acta Dermato-Venereologica, 103, adv00860.

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