Malignant melanoma and pregnancy.
Among 100 patients diagnosed with melanoma during pregnancy and followed a mean of 6.8 years, when compared with a nonpregnant female population, there was a significantly shorter disease-free interval for the pregnant group. Median disease-free intervals were 5.8 and 11.9 years, respectively. The time to development of lymph node metastases was shorter in the pregnant patients (p = 0.015). Nodal metastases developed in 48% of the pregnant patients and only 26% of the nonpregnant patients, at 10 years. Multivariate analysis demonstrated that pregnancy at diagnosis was significantly associated with the development of metastatic disease (p = 0.008), when controlling for tumor site, thickness, and Clark level. Pregnancy, however, was not a risk factor for patient mortality. The literature continues to be split on the role of pregnancy in melanoma; however, most recent series show no difference in survival. Multiple studies have failed to show significant effects of female hormones on melanoma cells or on the incidence or progression of melanoma.
Slingluff
C L
CL
Department of Surgery, Duke University Medical Center, Durham, NC.
Seigler
H F
HF
D000046:Academic Medical Centers; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000502:physiology; D006801:Humans; D008545:Melanoma / Q000150:complications / Q000401:mortality* / Q000473:pathology; D009362:Neoplasm Metastasis; D009657:North Carolina / Q000453:epidemiology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012878:Skin Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology; D015996:Survival Rate
D012739:Gonadal Steroid Hormones