Effect of pregnancy on survival in women with cutaneous malignant melanoma.
OBJECTIVE
An adverse influence of pregnancy on the risk of death in women with cutaneous melanoma was suggested historically by anecdotal reports. Previous studies included small numbers of women observed for short periods.


METHODS
Using data from the Swedish National and Regional Registries, we performed a retrospective cohort study of all Swedish women who were diagnosed with cutaneous melanoma during their reproductive period, from January 1, 1958, to December 31, 1999. The relationship between pregnancy status at the diagnosis of melanoma and overall survival was examined in multivariable proportional-hazards models.


RESULTS
The cohort comprised 185 women (3.3%) diagnosed with melanoma during pregnancy and 5,348 (96.7%) women of the same childbearing age diagnosed with melanoma while not pregnant. There was no statistically significant difference in overall survival between pregnant and nonpregnant groups (log-rank chi(2)1[r] = 0.84, P = .361). Pregnancy status at the time of diagnosis of melanoma was not related to survival in a multivariable Cox model in the 2,101 women (hazard ratio for death in the pregnant group was 1.08; 95% CI, 0.60 to 1.93). In the multivariable analysis, pregnancy status after diagnosis of melanoma was not a significant predictor of survival (hazard ratio for death in women who had pregnancy subsequent to the diagnosis of melanoma was 0.58; 95% CI, 0.32 to 1.05).


CONCLUSIONS
The survival of pregnant women with melanoma is not worse than the survival of nonpregnant women with melanoma. Pregnancy subsequent to the diagnosis of primary melanoma was not associated with an increased risk of death.
Lens
Marko B
MB
Genetic Epidemiology Division, Cancer Research UK, St James's University Hospital, Beckett St, Leeds LS9 7TF, UK. markolens@aol.com
Rosdahl
Inger
I
Ahlbom
Anders
A
Farahmand
Bahman Y
BY
Synnerstad
Ingrid
I
Boeryd
Bernt
B
Newton Bishop
Julia A
JA
D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008545:Melanoma / Q000401:mortality* / Q000473:pathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology