Use of Cyclooxygenase Inhibitors and Risk of Melanoma in High-Risk Patients

Authors

  • Claudia C. Ramirez MD,

    1. Department of Dermatology and Cutaneous Surgery, University of Miami, School of Medicine, Miami, Florida
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  • Fangchao Ma MD,PhD,

    1. Department of Dermatology and Cutaneous Surgery, University of Miami, School of Medicine, Miami, Florida
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  • Daniel G. Federman MD,

    1. Department of Internal Medicine, Yale University School of Medicine, VA Medical Center, West Haven, Connecticut
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  • Robert S. Kirsner MD,PhD

    Corresponding author
    1. Department of Dermatology and Cutaneous Surgery, University of Miami, School of Medicine, Miami, Florida
    2. Department of Epidemiology and Public Health, Miami, Florida
    3. Veterans Administration Medical Center, Miami, Florida
    4. Sylvester Cancer Center, University of Miami School of Medicine, Miami, Florida
      Address correspondence and reprint requests to: Robert S. Kirsner, MD, PhD, 1201 NW 16th Street, Suite 1206, Miami, FL 33125, or e-mail: Rkirsner@med.miami.edu.
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  • CLAUDIA C. RAMIREZ, MD, FANGCHAO MA, MD, PHD, DANIEL G. FEDERMAN, MD, AND ROBERT S. KIRSNER, MD, PHD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.

Address correspondence and reprint requests to: Robert S. Kirsner, MD, PhD, 1201 NW 16th Street, Suite 1206, Miami, FL 33125, or e-mail: Rkirsner@med.miami.edu.

Abstract

Background Results from in vitro and animal studies suggest that cyclooxygenase (COX) inhibitors may reduce the risk of melanoma, but among humans, the evidence remains limited.

Objective In a pilot retrospective cohort, to determine the relationship between the use of COX inhibitors and the incidence, recurrence, and metastases of melanoma in high-risk patients.

Methods Reviewing computerized records at the Miami Veterans Affairs Medical Center, we retrospectively examined the association between COX inhibitor use and melanoma incidence, recurrence, and metastases in high-risk subjects: white subjects previously diagnosed with melanoma (1996–2003). We evaluated three potential outcomes: new melanoma diagnosis, recurrence of a previous melanoma, and melanoma metastasis.

Results Eighty-three subjects with melanoma were included. There was one metastasis among 28 subjects prescribed COX inhibitors, whereas four new melanomas (7.3%), two melanoma recurrences, and six metastases (10.9%) occurred among 55 patients not prescribed COX inhibitors. Although no individual outcomes measures reached statistical significance, combining the three measures, these were significantly lower in users of COX inhibitors compared with nonusers (1 vs 12; p = .05). After adjustment for age and tumor depth of invasion, COX inhibitor users had significantly lower rates of melanoma outcome measures (odds ratio 0.08; 95% confidence interval 0.01–0.77; p = .03).

Conclusion Potential exists for chemoprevention of melanoma among high-risk patients.

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