The prognosis for malignant melanoma in the pregnant woman

Malignant melanoma: sex differences in survival after evidence of distant metastasis

“…The influence of pregnancy on the prognosis of cutaneous melanoma has been the subject of several clinical studies (Pack & Scharnagel, 1951;Greorge et al, 1960;White et al, 1961;Shinl et al, 1 976). From these studies it is not clear whether pregnancy at the time of diagnosis has an adverse effect on survival, or not.…”

Melanoma During Pregnancy

“…However, because the conclusions of these studies are inconsistent, it is still unclear whether pregnancy has impact to rapid tumor growth, more rapid occurrence of metastases, and poorer survival of patients (Sampson et al, 1998;Karagas et al, 2002). From the first report on this issue, which was published in 1951 (Pack & Scharnagel , 1983), up to the '80s of the last century almost all studies demonstrate poorer surviva l r a t e f r o m m e l a n o m a d i a g n o s e d u r i n g pregnancy (Pack et al, 1951;Sutherland et al, 1983;Trapeznikov et al, 1987;Reintgen et al, 1085;McManamny et al, 1989;Wong et al, 1989;Slingluff et al, 1990;MacKie et al, 1991;O'Meara et al, 2005;Katsambas et al, 1996;Lazovich et al, 2010;Osterlind et al, 1988;Smith MA et al, 1998;Shiu et al, 1976;Houghton et al, 1981). These findings were mostly the consequence of diagnosing tumors in their higher stages during the pregnancy than in case of tumor diagnosis in nonpregnant women of the same age (Shiu et al, 1976;Houghton et al, 1981;Landthaler & Braun-Falco, 1985), and frequent appearance of trunk melanoma (Houghton et al, 1981).…”

“…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).…”

The influence of pregnancy, parity, and sex on melanoma prognosis

“…The controversy began with a succession of case reports and case series that suggested a poorer prognosis for melanomas occurring during pregnancy with decreased survival rates (23)(24)(25)(26)(27)(28) and shorter disease-free intervals (29,30). Due to their small sample sizes and lack of control for disease stage they only provided anecdotal evidence.…”

“…There have been a handful of case reports, case series, (23,24,45) and some larger cohort studies (22,39,41) that have addressed this question with varied results. Earlier case reports raised concerns that a subsequent pregnancy may activate micrometatases from a previous melanoma based on the theoretical influence of pregnancy related hormones and growth factors (46,47).…”