Multiple primary melanomas: analysis of 49 cases.
Development of multiple primary melanomas is a rare but well recognized disease, with an estimated incidence ranging from 1.75% to 8.5% in several series. The clinical, histological and epidemiological characteristics of 49 patients, identified from 2470 with histologically confirmed melanoma, are described in this study. Thirty-five of these patients had two primary melanomas, 11 had three melanomas and three had four, five and six melanomas, respectively. Diagnosis was concurrent in 22 patients (45%); in the remaining cases the median time interval between the first and second melanoma was 22.6 months and the longest interval was 21.5 years. The mean Breslow's thickness decreased significantly (P < 0.001) from the first melanoma to the second and third lesion. The multiple melanoma patients had a higher percentage of subjects over 70 years of age or with lentigo maligna melanoma than single melanoma patients. The mean follow-up time was 12 years (range 4 23 years). The 5-year survival rate from first melanoma excision (83%) does not differ from that of patients with a single melanoma. In conclusion, the presence of multiple primary melanomas does not appear to be a negative prognostic factor; our data show the importance of close follow-up in melanoma patients in order to detect not only metastases, but also subsequent primaries in their earliest phases.
First Dermatologic Clinic, University of Turin, Torino, Italy.
P
P
Savoia
P
P
Quaglino
A
A
Verrone
M G
MG
Bernengo
D000368:Aged; D004416:Dysplastic Nevus Syndrome / Q000453:epidemiology / Q000235:genetics; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D011379:Prognosis; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D016019:Survival Analysis; D015996:Survival Rate