Retrospective Analysis of Clinicopathological Characteristics of Pregnancy Associated Melanoma
Abstract
Pregnancy associated melanoma (PAM) by definition appears during pregnancy or within 1 year after delivery. In this retrospective study we analysed the pathological characteristics and survival rate of PAM and matched the data with non-pregnant age- and stage-matched control patients. Between 2003 and 2014, 34 pregnant women (aged 32.5 ± 5.6 years) were diagnosed with melanoma at the Department of Dermatology, Venereology and Dermatooncology of the Semmelweis University. During the pathological process histologic subtype, Breslow thickness and Clark level, tumor cell type, mitotic rate, peritumoral inflammation, as well as ulceration, regression, necrosis, vascular invasion and presence of satellite were analyzed and related to clinical data. Primary tumor location and clinical staging, disease course, local recurrence and metastases, 5-year survival rate, other tumor development before or after the diagnosis of melanoma have also been documented. We found no difference in all parameters between pregnant and non-pregnant melanoma cases except peritumoral inflammation which was higher in PAM group, moreover the presence of mild inflammation was significantly higher in PAM group compared to non-pregnancy associated melanoma (NPAM) women group.
Keywords
Melanoma Pregnancy Postpartum Young womenNotes
Acknowledgments
This study was supported by the Hungarian Scientific Research Fund [OTKA 83023, 112612 and OTKA NN 114460].
Conflict to Interest
The authors declare that they have no conflicts of interest.
References
- 1.Tomao F, Papa A, Lo Russo G, Zuber S, Spinelli GP, Rossi L, Caruso D, Prinzi N, Stati V, Benedetti Panici P, Tomao S (2014) Correlation between fertility drugs use and malignant melanoma incidence: the state of the art. Tumour Biol 35(9):8415–8424CrossRefPubMedGoogle Scholar
- 2.Driscoll MS, Grant-Kels JM (2007) Hormones, nevi, and melanoma: an approach to the patient. J Am Acad Dermatol 57(6):919–931, quiz 932–6 CrossRefPubMedGoogle Scholar
- 3.Smith LH, Dalrymple JL, Leiserowitz GS, Danielsen B, Gilbert WM (2001) Obstetrical deliveries associated with maternal malignancy in California, 1992 through 1997. Am J Obstet Gynecol 184(7):1504–1512, discussion 1512–3 CrossRefPubMedGoogle Scholar
- 4.Zick CD, Smith KR, Mayer RN, Taylor LB (2014) Family, frailty, and fatal futures? Own-health and family-health predictors of subjective life expectancy. Res Aging 36(2):244–266CrossRefPubMedGoogle Scholar
- 5.Pentheroudakis G, Orecchia R, Hoekstra HJ, Pavlidis N, Group EGW (2010) Cancer, fertility and pregnancy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v266–v273CrossRefPubMedGoogle Scholar
- 6.Andersson TM, Johansson AL, Fredriksson I, Lambe M (2015) Cancer during pregnancy and the postpartum period: a population-based study. CancerGoogle Scholar
- 7.Zhou JH, Kim KB, Myers JN, Fox PS, Ning J, Bassett RL, Hasanein H, Prieto VG (2014) Immunohistochemical expression of hormone receptors in melanoma of pregnant women, nonpregnant women, and men. Am J Dermatopathol 36(1):74–79PubMedCentralCrossRefPubMedGoogle Scholar
- 8.Stensheim H, Moller B, van Dijk T, Fossa SD (2009) Cause-specific survival for women diagnosed with cancer during pregnancy or lactation: a registry-based cohort study. J Clin Oncol 27(1):45–51CrossRefPubMedGoogle Scholar
- 9.Eibye S, Kjaer SK, Mellemkjaer L (2013) Incidence of pregnancy-associated cancer in Denmark, 1977–2006. Obstet Gynecol 122(3):608–617CrossRefPubMedGoogle Scholar
- 10.Lens MB, Rosdahl I, Ahlbom A, Farahmand BY, Synnerstad I, Boeryd B, Newton Bishop JA (2004) Effect of pregnancy on survival in women with cutaneous malignant melanoma. J Clin Oncol 22(21):4369–4375CrossRefPubMedGoogle Scholar
- 11.Frishberg DP, Balch C, Balzer BL, Crowson AN, Didolkar M, McNiff JM, Perry RR, Prieto VG, Rao P, Smith MT, Smoller BR, Wick MR, C.o.A.P. Members of the Cancer Committee (2009) Protocol for the examination of specimens from patients with melanoma of the skin. Arch Pathol Lab Med 133(10):1560–1567PubMedGoogle Scholar
- 12.Clayton SG (1946) Melanoma of the vulva with pregnancy. Proc R Soc Med 39(9):578–579Google Scholar
- 13.Moller H, Purushotham A, Linklater KM, Garmo H, Holmberg L, Lambe M, Yallop D, Devereux S (2013) Recent childbirth is an adverse prognostic factor in breast cancer and melanoma, but not in Hodgkin lymphoma. Eur J Cancer 49(17):3686–3693CrossRefPubMedGoogle Scholar
- 14.Scoggins CR, Ross MI, Reintgen DS, Noyes RD, Goydos JS, Beitsch PD, Urist MM, Ariyan S, Sussman JJ, Edwards MJ, Chagpar AB, Martin RC, Stromberg AJ, Hagendoorn L, McMasters KM, Sunbelt Melanoma T (2006) Gender-related differences in outcome for melanoma patients. Ann Surg 243(5):693–698, discussion 698–700 PubMedCentralCrossRefPubMedGoogle Scholar
- 15.Sanlorenzo M, Ribero S, Osella-Abate S, Zugna D, Marenco F, Macripo G, Fierro MT, Bernengo MG, Quaglino P (2014) Prognostic differences across sexes in melanoma patients: what has changed from the past? Melanoma Res 24(6):568–576CrossRefPubMedGoogle Scholar
- 16.Gamba CS, Clarke CA, Keegan TH, Tao L, Swetter SM (2013) Melanoma survival disadvantage in young, non-Hispanic white males compared with females. JAMA Dermatol 149(8):912–920CrossRefPubMedGoogle Scholar
- 17.Nosrati A, Wei ML (2014) Sex disparities in melanoma outcomes: the role of biology. Arch Biochem Biophys 563C:42–50CrossRefGoogle Scholar
- 18.Joosse A, de Vries E, Eckel R, Nijsten T, Eggermont AM, Holzel D, Coebergh JW, Engel J, Munich Melanoma G (2011) Gender differences in melanoma survival: female patients have a decreased risk of metastasis. J Invest Dermatol 131(3):719–726CrossRefPubMedGoogle Scholar
- 19.Kanda N, Watanabe S (2001) 17beta-estradiol, progesterone, and dihydrotestosterone suppress the growth of human melanoma by inhibiting interleukin-8 production. J Invest Dermatol 117(2):274–283CrossRefPubMedGoogle Scholar
- 20.O’Meara AT, Cress R, Xing G, Danielsen B, Smith LH (2005) Malignant melanoma in pregnancy. A population-based evaluation. Cancer 103(6):1217–1226CrossRefPubMedGoogle Scholar
- 21.Daryanani D, Plukker JT, De Hullu JA, Kuiper H, Nap RE, Hoekstra HJ (2003) Pregnancy and early-stage melanoma. Cancer 97(9):2248–2253CrossRefPubMedGoogle Scholar
- 22.Johansson AL, Andersson TM, Plym A, Ullenhag GJ, Moller H, Lambe M (2014) Mortality in women with pregnancy-associated malignant melanoma. J Am Acad Dermatol 71(6):1093–1101CrossRefPubMedGoogle Scholar
- 23.Byrom L, Olsen C, Knight L, Khosrotehrani K, Green AC (2015) Increased mortality for pregnancy-associated melanoma: systematic review and meta-analysis. J Eur Acad Dermatol VenereolGoogle Scholar
- 24.Travers RL, Sober AJ, Berwick M, Mihm MC Jr, Barnhill RL, Duncan LM (1995) Increased thickness of pregnancy-associated melanoma. Br J Dermatol 132(6):876–883CrossRefPubMedGoogle Scholar
- 25.Massi D, Franchi A, Borgognoni L, Reali UM, Santucci M (1999) Thin cutaneous malignant melanomas (< or =1.5 mm): identification of risk factors indicative of progression. Cancer 85(5):1067–1076CrossRefPubMedGoogle Scholar
- 26.Ladanyi A, Somlai B, Gilde K, Fejos Z, Gaudi I, Timar J (2004) T-cell activation marker expression on tumor-infiltrating lymphocytes as prognostic factor in cutaneous malignant melanoma. Clin Cancer Res 10(2):521–530CrossRefPubMedGoogle Scholar
- 27.Fortes C, Mastroeni S, Manooranparanpampil T, Passarelli F, Zappala A, Marino C, Russo N, Michelozzi P (2015) Tumor-infiltrating lymphocytes predict cutaneous melanoma survival. Melanoma Res. 25(4)306–11Google Scholar
- 28.Toth V, Somlai B, Harsing J, Hatvani Z, Karpati S (2013) Stage distribution of malignant melanomas in a Hungarian centre. Orv Hetil 154(25):969–976CrossRefPubMedGoogle Scholar