Identification of death risk factors of primary melanoma based on the competing risk model

Summary Objective To preliminarily explore death risk factors in primary melanoma patients. Method Competing risk model analysis was used using a large sample public cohort and Cox proportional hazard model was compared. Result In the competing risk model analysis, age, gender, ethnicity, stage, site, TMN stage and metastases were the independent risk factors of single primary melanoma (SPM) death. T stage had a particularly important impact on SPM death. T2 stage had a 3.212 times greater risk of interest event than T1 stage [hazard ratio (HR) = 3.212, 95%CI: 2.994–3.446], T3 stage was 5.747 times greater than that T1 stage (HR = 5.747, 95%CI: 5.337–6.187) and T4 stage had a 7.086 times than T1 stage (HR = 7.086, 95%CI: 6.514–7.708). Gender, ethnicity, stage, site, T stage and brain and liver metastases were the independent risk factors of multiple primary melanoma (MPM) death. When some groups had a very high death rate or the reference group had a very low death rate in competing events, the results of Cox proportional hazard model may not be as accurate as the results obtained by fine-Gray regression model. Conclusion Early diagnosis and therapy, and prevention of tumor progression and metastases of primary melanoma patients are important measures to improve its prognosis and survival.