Real World Data in Stage III Melanoma in Latino Low Middle Income Country: Prognostic Factors and Outcomes

Malignant melanoma is a heterogeneous disease, with varying outcomes depending on the patient's race and ethnicity. Advanced stages can be tackled by novel targeted therapies and immunotherapy. We aimed to investigate the real-world data in Latino-Hispanic patients diagnosed with Stage III melanoma residing in Peru, a region marked by limited resources and healthcare infrastructure. Patients diagnosed with Stage III melanoma at the Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru were included from the years 2010 to 2020. Cox regression analysis was used to assess prognostic factors. Four hundred twelve patients were included, the median age of diagnosis was 63 years, with a male predominance (55.6%). Most of the patients presented with a lesion in the lower extremities (77.4%), acral lentiginous melanoma (35.4%), and ulcerated tumors (72.3%). 64.1% were diagnosed with Stage IIIC, and 27.2% received interferon-alpha therapy. With a median follow-up of 36 months, the relapse-free survival and overall survival rates were 26% and 78% at 3 years follow-up, respectively. Prognostic factors of event-free survival (EFS) were greater age (HR = 1.015, 95% CI: 1.005-1.025), ulcerated lesions (HR = 1.855, 95% CI: 1.221-2.820), N category, and the administration of interferon therapy (HR = 0.680, 95% CI: 0.488-0.947). While worse overall survival (OS) was associated with greater ages (HR = 1.032, 95% CI: 1.011-1.053) and the presence of ulceration (HR = 2.992, 95% CI:1.142-7.835). Stage III melanoma in the Hispanic-Latino population from Peru has worse survival rates than other races and populations despite similar prognostic factors of worse EFS and OS. In resource-limited settings, reducing barriers to receiving healthcare and broadening access to contemporary immunotherapy and targeted therapy are crucial measures to improve outcomes in patients with advanced melanoma.