Malignant melanoma and pregnancy

Abstract

Confusion exists concerning the influence of pregnancy on survival in patients with malignant melanoma. To evaluate this problem a retrospective computer‐aided study was performed of women in the child‐bearing years treated for Stage I cutaneous melanoma at the Duke University Comprehensive Cancer Center. Fifty‐eight women were identified who had melanoma arise during pregnancy (Group 1) and 43 patients were noted who became pregnant within 5 years of diagnosis of their melanoma (Group 2). Appropriate control groups matched for the clinical variables of age, primary site, and stage of disease and the pathologic variables of Clark's Level, tumor thickness, ulceration, and histologic type were selected from the cohort of 2938 melanoma patients seen at Duke. Actuarial survivals for Group 1 and 2 patients did not differ from their respective controls, although the small number of deaths in each group resulted in wide confidence intervals. When actuarial disease‐free intervals were plotted, there was a significant difference beween women who had melanoma develop during pregnancy when compared to their controls (P = 0.04). In a multivariate regression analysis, after adjustment for the influence of the more significant prognostic factors for Stage 1 melanoma, including Clark's Level, ulceration, and tumor thickness, the effect of pregnancy on disease‐free interval became more apparent (P = 0.02). No difference in actuarial disease‐free interval was noted in the melanoma patients who elected to become pregnant within 5 years of diagnosis (P = 0.31). A multivariate regression analysis confirmed this finding. These data indicate that although an intercurrent melanoma during pregnancy has a worse prognosis than the control groups, once a woman has been diagnosed as having a cutaneous melanoma, a subsequent pregnancy has no effect on recurrence rate or survival. Cancer 55:1340‐1344, 1985.

Metastatic Malignant Melanoma of The Stomach in an Oculocutaneous Albino Patient: First Case

“…4 In studies on gastrointestinal system, metastasis was observed to small intestine, colon and stomach at percentages of 35-70%, 14.5-2.2% and 7-20% respectively. 5,6 Gastrointestinal system melanoma could be detected primarily or metastatically. One of the hypothesis for the development of gastric melanoma is the development from ectopic melanocytes at the gastric wall as a result of the migration of melanocytes to gastrointestinal system during embryogenesis.…”

Melanoma During Pregnancy

“…The results of all studies show that pregnancy after the treatment of melanoma is safe (Lens et al, 2004;Sutherland et al, 1983;Reintgen et al, 1985;Wong et al, 1989;MacKie et al, 1991;71 28, Driscoll et al, 1993;o'Meara et al, 2005;Driscoll & Grant-Kels, 2008). The risk of disease recurrence is mainly associated with the stage of the disease before the diagnosis and thus the opinion that the patient's decision regarding the pregnancy should be based on the level of that risk (MacKie et al, 1991).…”

“…The effect of pregnancy to the course of melanoma has been a researching issue for years. The results of uncontrolled studies conducted from 1950 to 1980 show that pregnancy is an unfavorable prognostic factor in patients' survival (Pack & Scharnagel, 1951;Sutherland et al, 1983;Trapeznikov et al, 1987 ), but the reports of recent controlled studies oppose this finding (Lens et al, 2004;Reintgen et al, 1985;McManamny et al, 1989;Wong et al, 1989;Slingluff et al, 1990;MacKie et al, 1991). The most recent population studies demonstrate equal survival among women with the same melanoma stage regardless they are pregnant or not (Lens et al, 2004;O'Meara et al, 2005).…”

State of the science 60th anniversary review

“…32 Another study suggested that having a subsequent pregnancy had no effects on recurrence rate or survival. 33 More recently, a study from Germany highlighted that pregnancy did not appear to have an adverse long-term effect on survival in patients with clinically localized melanoma. 34 Currently, there is broad agreement that prognosis for women with melanoma during pregnancy, just as for nonpregnant women and for men, is primarily dependent on tumor thickness and ulceration.…”