Postdiagnosis aspirin use and overall survival in patients with melanoma.

BACKGROUND: Mouse studies show that tumor-derived prostaglandins and platelets promote melanoma progression and immune evasion. OBJECTIVE: Determine whether aspirin confers longer survival in patients with melanoma. METHODS: A retrospective cohort study of 1522 patients at Indiana University Health who had melanoma diagnosed between 2000 and 2014 and were followed up through September 2016. RESULTS: Aspirin use was associated with longer overall survival in univariate analysis and after controlling for age, sex, stage, and treatment modalities (hazard ratio [HR], 0.58; 95% confidence interval [CI], 0.45-0.75). Aspirin use was not associated with survival in patients with in situ and stage I melanoma but was associated with better survival in stages II (HR, 0.45; 95% CI, 0.24-0.82) and III (HR, 0.57; 95% CI; 0.34-0.96). No statistical significance was observed in stage IV patients (HR, 0.55; 95% CI, 0.27-1.13). In turn, melanoma in patients using aspirin before diagnosis was less likely to be diagnosed in stages III or IV. LIMITATIONS: Observational study. CONCLUSIONS: Aspirin could provide a survival advantage in melanoma. Clinical trials investigating the therapeutic potential of aspirin are warranted.