[Increased risk of developing a second primary cutaneous nevus-associated melanoma in patients previously diagnosed with the disease].
BACKGROUND
Patients diagnosed with primary cutaneous melanoma have a greater lifetime risk of developing further melanomas. Most of these melanomas appear to arise de novo, but a proportion of them develop in pre-existing melanocytic nevi.


OBJECTIVE
To determine risk factors associated with the development of a second cutaneous melanoma arising on a nevus in patients diagnosed with cutaneous melanoma.


METHODS
A series of 981 patients diagnosed with cutaneous melanoma was selected; 47 of them had been diagnosed with a second melanoma. These 47 patients were classified into 2 groups according to whether or not there was histological evidence that the melanoma was associated with a nevus.


RESULTS
Age at diagnosis less than 40 years, tumor location on the trunk, and superficial spreading subtype were independent risk factors for the appearance of a primary melanoma on a nevus. The only factor associated with the appearance of a second nevus-associated melanoma was that the first melanoma was also associated with a nevus (odds ratio, 9.51; 95% confidence interval 1.6-56.56; P=.042).


CONCLUSIONS
Nevus-associated melanomas develop mainly in young patients, on the trunk, and are of the superficial spreading subtype. A history of primary cutaneous melanoma arising on a nevus is associated with a 9-fold increase in the risk of developing a second nevus-associated melanoma. These findings highlight the need for careful follow-up of all melanocytic lesions in patients who have had a primary nevus-associated melanoma.
Instituto Valenciano de Oncología, Valencia, España.
B
B
Echeverría
R
R
Botella-Estrada
C
C
Serra-Guillén
A
A
Martorell
V
V
Traves
C
C
Requena
O
O
Sanmartín
B
B
Llombart
C
C
Guillén
E
E
Nagore
D000328:Adult; D000368:Aged; D002056:Burns / Q000453:epidemiology; D002471:Cell Transformation, Neoplastic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008544:Melanocytes / Q000473:pathology; D008545:Melanoma / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D009508:Nevus, Pigmented / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D010858:Pigmentation; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D012867:Skin / Q000293:injuries; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology