The following is a summary of “Role of Sleep Apnea and Long-Term CPAP Treatment in the Prognosis of Patients With Melanoma: A Prospective Multicenter Study of 443 Patients,” published in the December 2023  issue of Pulmonology by Gómez-Olivas, et al.

Melanoma is more common and spreads more quickly in people with OSA. However, more research needs to be done on how OSA and CPAP treatment affect the outlook of melanoma in the long run. Between 2012 and 2015, 443 people diagnosed with skin melanoma had a sleep study within 6 months of being diagnosed. 

The study’s main result after 5 years was either a melanoma return, spread, or death. They put the patients into four groups based on their OSA severity: those with no OSA (control group) had an apnea-hypopnea index (AHI) of less than 10 events/h; those with intermediate OSA (AHI, 10–29 events/h) or poor CPAP adherence had an AHI of 10–29 events/h; and those with severe OSA (AHI, 30 events or more). Survival analysis found the separate effects of OSA and CPAP treatment on the overall result of melanoma.

They could look at 391 patients, or 88.2%, at the 5-year follow-up. Their average age was 65.1 ± 15.2 years, and 49% were men. Their Breslow index was 1.7 ± 2.5 mm. One hundred thirty-nine patients in the control group had an AHI of less than 10 events/h. Of those with OSA, 78 were compliant with CPAP, while 124 and 50 had mild and severe OSA, respectively, without CPAP treatment. The average time between follow-ups was 60 months, ranging from 51 to 74 months. 

In the following years, there were 32 relapses, 53 metastases, and 52 deaths (116 patients had at least one of the main aggregate outcomes). After taking into account factors like age, gender, BMI, diabetes, having an oxygen saturation level below 90% at night, the Breslow index, the Epworth sleepiness scale scores, and the type of melanoma being treated, moderate (HR, 2.45; 95% CI, 1.09–5.49) and severe OSA (HR, 2.96; 95% CI, 1.36–6.42) OSA was linked to a worse prognosis of melanoma compared to the control group. Good CPAP use, on the other hand, kept this extra risk from happening (HR, 1.66; 95% CI, 0.71-3.90). Untreated moderate to severe OSA is a risk factor in and of itself for a bad outlook of melanoma. Treatment with CPAP was linked to better results for cancer patients compared to those who don’t get treatment for mild to severe OSA.

Source: sciencedirect.com/science/article/abs/pii/S0012369223008917