Survival and Economic Burden of Melanoma: A Retrospective Cohort Analysis in South Korea

There is limited evidence available on burdens of melanoma and this study was conducted to evaluate the mortality and medical costs for melanoma in South Korea using a nationwide medical claims database 2002-2017. Melanoma patients and their matched controls were compared and categorized into operation only (OP), chemotherapy or radiation therapy (CTx/RTx), and combined therapy of OP+CTx/RTx. Mortality was analyzed using the Kaplan-Meier method and the Cox proportional hazard regression. Survival rates for 5-year or 10-year periods were 62.3% or 48.8% in total patients, and tended to decrease in the order of OP, OP+CTx/RTx, and CTx/RTx group. The hazard ratio (HR) was the highest in the CTx/RTx group (HR: 6.30), followed by OP+CTx/RTx (HR: 5.28) and OP (HR: 2.44). The medical costs for total patients for 5 years after diagnosis was 1.8 times of controls. The ratio of medical cost per survived month between patients and controls was the lowest in the OP group as 1.52 compared to 2.50 of the OP+CTx/RTx group or 2.49 of the CTx/RTx group. Overall burden of melanoma is substantial and estimating mortality and economic burden of melanoma varies by disease stage and treatment modality.