title: High nevus counts confer a favorable prognosis in melanoma patients.
abstract: A high number of nevi is the most significant phenotypic risk factor for melanoma and is in part genetically determined. The number of nevi decreases from middle age onward but this senescence can be delayed in patients with melanoma. We investigated the effects of nevus number count on sentinel node status and melanoma survival in a large cohort of melanoma cases. Out of 2,184 melanoma cases, 684 (31.3%) had a high nevus count (>50). High nevus counts were associated with favorable prognostic factors such as lower Breslow thickness, less ulceration and lower mitotic rate, despite adjustment for age. Nevus count was not predictive of sentinel node status. The crude 5- and 10-year melanoma-specific survival rate was higher in melanomas cases with a high nevus count compared to those with a low nevus count (91.2 vs. 86.4% and 87.2 vs. 79%, respectively). The difference in survival remained significant after adjusting for all known melanoma prognostic factors (hazard ratio [HR] = 0.43, confidence interval [CI] = 0.21-0.89). The favorable prognostic value of a high nevus count was also seen within the positive sentinel node subgroup of patients (HR = 0.22, CI = 0.08-0.60). High nevus count is associated with a better melanoma survival, even in the subgroup of patients with positive sentinel lymph node. This suggests a different biological behavior of melanoma tumors in patients with an excess of nevi.
authors: Department of Twin Research & Genetic Epidemiology, King's College London, London, United Kingdom.|Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.|Department of Dermatology, London North West Healthcare NHS Trust Northwick Park Hospital, London, United Kingdom.|Imperial College London, London, United Kingdom.
authors: Simone
authors: S
authors: Ribero
authors: Section of Epidemiology and Biostatistics, LICAP, University of Leeds, Leeds, United Kingdom.
authors: John R
authors: JR
authors: Davies
authors: Department of Dermatology, Instituto Valenciano De Oncologıa, Valencia, Spain.
authors: Celia
authors: C
authors: Requena
authors: Department of Dermatology, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain.
authors: Cristina
authors: C
authors: Carrera
authors: Department of Twin Research & Genetic Epidemiology, King's College London, London, United Kingdom.|Department of Dermatology, London North West Healthcare NHS Trust Northwick Park Hospital, London, United Kingdom.|Imperial College London, London, United Kingdom.
authors: Daniel
authors: D
authors: Glass
authors: Department of Surgery, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain.
authors: Ramon
authors: R
authors: Rull
authors: Department of Nuclear Medicine Service, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain.
authors: Sergi
authors: S
authors: Vidal-Sicart
authors: Department of Dermatology, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain.
authors: Antonio
authors: A
authors: Vilalta
authors: Department of Pathology Service, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain.
authors: Lucia
authors: L
authors: Alos
authors: Department of Oncology, Instituto Valenciano De Oncologıa, Valencia, Spain.
authors: Virtudes
authors: V
authors: Soriano
authors: Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.
authors: Pietro
authors: P
authors: Quaglino
authors: Department of Pathology, Instituto Valenciano De Oncologıa, Valencia, Spain.
authors: Victor
authors: V
authors: Traves
authors: Section of Epidemiology and Biostatistics, LICAP, University of Leeds, Leeds, United Kingdom.
authors: Julia A
authors: JA
authors: Newton-Bishop
authors: Department of Dermatology, Instituto Valenciano De Oncologıa, Valencia, Spain.
authors: Eduardo
authors: E
authors: Nagore
authors: Department of Dermatology, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain.|Instituto de Salud Carlos III, CIBER on Rare Diseases, Barcelona, Spain.
authors: Josep
authors: J
authors: Malvehy
authors: Department of Dermatology, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain.|Instituto de Salud Carlos III, CIBER on Rare Diseases, Barcelona, Spain.
authors: Susana
authors: S
authors: Puig
authors: Department of Twin Research & Genetic Epidemiology, King's College London, London, United Kingdom.|Department of Dermatology, West Herts NHS Trust, Hertfordshire, United Kingdom.
authors: Veronique
authors: V
authors: Bataille
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000473:pathology; D008875:Middle Aged; D009506:Nevus / Q000453:epidemiology* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: melanoma; nevus count; sentinel lymph node; survival