Pregnancy-associated melanoma: characteristics and outcomes from 2002 to 2020.
Journal
Melanoma research
ISSN: 1473-5636
Titre abrégé: Melanoma Res
Pays: England
ID NLM: 9109623
Informations de publication
Date de publication:
23 Jan 2024
23 Jan 2024
Historique:
medline:
24
1
2024
pubmed:
24
1
2024
entrez:
24
1
2024
Statut:
aheadofprint
Résumé
Melanoma diagnosed within 1 year of pregnancy is defined as pregnancy-associated melanoma (PAM). No robust data on how pregnancy influences melanoma nor guidelines for PAM management exist. With IRB approval, female patients with a pathology-confirmed melanoma diagnosis within 1 year of pregnancy treated at our institution from 2000 to 2020 were identified. Controls from the cancer registry were matched 1 : 4 when available on decade of age, year of surgery (±5), and stage. We identified 83 PAM patients with median follow-up of 86 months. Mean age at diagnosis was 31 years. 80% AJCC V8 stage I, 2.4% stage II, 13% stage III, 4.8% stage IV. Mean Breslow thickness was 0.79 mm and 3.6% exhibited ulceration. The mean mitotic rate was 0.76/mm2. In terms of PAM management, 98.6% of ESD patients and 86.7% of LSD patients received standard-of-care therapy per NCCN guidelines for their disease stage. No clinically significant delays in treatment were noted. Time to treatment from diagnosis to systemic therapy for LSD patients was an average of 46 days (95% CI: 34-59 days). Comparing the 83 PAM patients to 309 controls matched on age, stage, and year of diagnosis, similar 5-year overall survival (97% vs. 97%, P = 0.95) or recurrence-free survival (96% vs. 96%, P = 0.86) was observed. The outcomes of PAM following SOC treatment at a highly specialized center for melanoma care were comparable to non-PAM when matched by clinical-pathologic features. Specialty center care is encouraged for women with PAM.
Identifiants
pubmed: 38265469
doi: 10.1097/CMR.0000000000000953
pii: 00008390-990000000-00127
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Références
Lens M, Bataille V. Melanoma in relation to reproductive and hormonal factors in women: current review on controversial issues. Cancer Causes Control 2008; 19:437–442.
Watson M, Geller AC, Tucker MA, Guy GP Jr, Weinstock MA. Melanoma burden and recent trends among non-Hispanic whites aged 15-49 years, United States. Prev Med 2016; 91:294–298.
Andersson TM, Johansson AL, Fredriksson I, Lambe M. Cancer during pregnancy and the postpartum period: a population-based study. Cancer 2015; 121:2072–2077.
Zelin E, Conforti C, Giuffrida R, Deinlein T, Meo ND, Zalaudek I. Melanoma in pregnancy: certainties unborn. Melanoma Manag 2020; 7:MMT48.
Aktürk AS, Bilen N, Bayrämgürler D, Demirsoy EO, Erdogan S, Kiran R. Dermoscopy is a suitable method for the observation of the pregnancy-related changes in melanocytic nevi. J Eur Acad Dermatol Venereol 2007; 21:1086–1090.
Chan MP, Chan MM, Tahan SR. Melanocytic nevi in pregnancy: histologic features and Ki-67 proliferation index. J Cutan Pathol 2010; 37:843–851.
Rubegni P, Sbano P, Burroni M, Cevenini G, Bocchi C, Severi FM, et al. Melanocytic skin lesions and pregnancy: digital dermoscopy analysis. Skin Res Technol 2007; 13:143–147.
Zampino MR, Corazza M, Costantino D, Mollica G, Virgili A. Are melanocytic nevi influenced by pregnancy? A dermoscopic evaluation. Dermatol Surg 2006; 32:1497–1504.
Nading MA, Nanney LB, Boyd AS, Ellis DL. Estrogen receptor beta expression in nevi during pregnancy. Exp Dermatol 2008; 17:489–497.
Facina AS, Facina G, Guerreiro da Silva IDC, Corrêa SAA, Alexandre SM, Logullo AF, et al. Pregnancy and the apoptotic pathway in experimental melanoma. Melanoma Res 2018; 28:286–294.
Ellis DL. Pregnancy and sex steroid hormone effects on nevi of patients with the dysplastic nevus syndrome. J Am Acad Dermatol 1991; 25:467–482.
Lens MB, Reiman T, Husain AF. Use of tamoxifen in the treatment of malignant melanoma. Cancer 2003; 98:1355–1361.
Byrom L, Olsen C, Knight L, Khosrotehrani K, Green AC. Increased mortality for pregnancy-associated melanoma: systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2015; 29:1457–1466.
Kyrgidis A, Lallas A, Moscarella E, Longo C, Alfano R, Argenziano G. Does pregnancy influence melanoma prognosis? A meta-analysis. Melanoma Res 2017; 27:289–299.
Shiu MH, Schottenfeld D, Maclean B, Fortner JG. Adverse effect of pregnancy on melanoma: a reappraisal. Cancer 1976; 37:181–187.
Slingluff CL Jr, Reintgen DS, Vollmer RT, Seigler HF. Malignant melanoma arising during pregnancy A study of 100 patients. Ann Surg 1990; 211:552–7; discussion 558–9.
Jones MS, Lee J, Stern SL, Faries MB. Is pregnancy-associated melanoma associated with adverse outcomes? J Am Coll Surg 2017; 225:149–158.
Lens MB, Rosdahl I, Ahlbom A, Farahmand BY, Synnerstad I, Boeryd B, et al. Effect of pregnancy on survival in women with cutaneous malignant melanoma. J Clin Oncol 2004; 22:4369–4375.
O’Meara AT, Cress R, Xing G, Danielsen B, Smith LH. Malignant melanoma in pregnancy A population-based evaluation. Cancer 2005; 103:1217–1226.
American College of Obstetricians and Gynecologists' Committee on Obstetric Practice. Committee opinion no. 656: guidelines for diagnostic imaging during pregnancy and lactation. Obstet Gynecol 2016; 127:e75–e80.
Burotto M, Gormaz JG, Samtani S, Valls N, Silva R, Rojas C, et al. Viable Pregnancy in a patient with metastatic melanoma treated with double checkpoint immunotherapy. Semin Oncol 2018; 45:164–169.
Bichakjian CK, Halpern AC, Johnson TM, Foote Hood A, Grichnik JM, Swetter SM, et al.; American Academy of Dermatology. Guidelines of care for the management of primary cutaneous melanoma American Academy of Dermatology. J Am Acad Dermatol 2011; 65:1032–1047.
Cordeiro CN, Gemignani ML. Breast cancer in pregnancy: avoiding fetal harm when maternal treatment is necessary. Breast J 2017; 23:200–205.
Toesca A, Gentilini O, Peccatori F, Azim HA Jr, Amant F. Locoregional treatment of breast cancer during pregnancy. Gynecol Surg 2014; 11:279–284.
Schwartz JL, Mozurkewich EL, Johnson TM. Current management of patients with melanoma who are pregnant, want to get pregnant, or do not want to get pregnant. Cancer 2003; 97:2130–2133.
Maleka A, Enblad G, Sjors G, Lindqvist A, Ullenhag GJ. Treatment of metastatic malignant melanoma with vemurafenib during pregnancy. J Clin Oncol 2013; 31:e192–e193.
Mittra A, Naqash AR, Murray JH, Finnigan S, Kwak-Kim J, Ivy SP, et al. Outcomes of pregnancy during immunotherapy treatment for cancer: analysis of clinical trials sponsored by the National Cancer Institute. Oncologist. 2021; 26:e1883–e1886.
Mathew M, Sheik S, Rao K, Burney IA, Sawhney S, Al-Hamdani A. Metastatic malignant melanoma during pregnancy: case report and a review of the literature. Sultan Qaboos Univ Med J 2009; 9:79–83.
Alexander A, Samlowski WE, Grossman D, Bruggers CS, Harris RM, Zone JJ, et al. Metastatic melanoma in pregnancy: risk of transplacental metastases in the infant. J Clin Oncol 2003; 21:2179–2186.
Møller H, Purushotham A, Linklater KM, Garmo H, Holmberg L, Lambe M, et al. Recent childbirth is an adverse prognostic factor in breast cancer and melanoma, but not in Hodgkin lymphoma. Eur J Cancer 2013; 49:3686–3693.
Stensheim H, Møller B, van Dijk T, Fosså SD.Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol 2009; 27:45–51.
Silipo V, De Simone P, Mariani G, Buccini P, Ferrari A, Catricala C. Malignant melanoma and pregnancy. Melanoma Res 2006; 16:497–500.
Johansson AL, Andersson TM, Plym A, Ullenhag GJ, Møller H, Lambe M. Mortality in women with pregnancy-associated malignant melanoma. J Am Acad Dermatol 2014; 71:1093–1101.
de Haan J, Lok CA, de Groot CJ, Crijns MB, Van Calsteren K, Dahl Steffensen K, et al.; International Network on Cancer, Infertility and Pregnancy (INCIP). Melanoma during pregnancy: a report of 60 pregnancies complicated by melanoma. Melanoma Res 2017; 27:218–223.
Lambe M, Thörn M, Sparén P, Bergström R, Adami HO. Malignant melanoma: reduced risk associated with early childbearing and multiparity. Melanoma Res 1996; 6:147–153.
Brady MS, Noce NS. Pregnancy is not detrimental to the melanoma patient with clinically localized disease. J Clin Aesthet Dermatol 2010; 3:22–28.
Byrom L, Olsen CM, Knight L, Khosrotehrani K, Green AC. Does pregnancy after a diagnosis of melanoma affect prognosis? Systematic review and meta-analysis. Dermatol Surg 2015; 41:875–882.
MacKie RM, Bufalino R, Morabito A, Sutherland C, Cascinelli N. Lack of effect of pregnancy on outcome of melanoma For The World Health Organisation Melanoma Programme. Lancet 1991; 337:653–655.
Centers for Disease Control and Prevention. Melanoma Incidence and Mortality, United States–2012–2016. USCS Data Brief, no. 9. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2019.