Risk factors and outcomes of cutaneous melanoma in women less than 50 years of age

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• 作者：Alejandra Tellez ; MD^b ; Steven Rueda ; MD^a ; Ruzica Z. Conic ; MD^b ; Kristin Powers ; BS^c ; Izabela Galdyn ; MD^d ; Natasha Atanaskova Mesinkovska ; MD ; PhD^b ; Brian Gastman ; MD^a ; ^{gastmab@ccf.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：melanoma ; pregnancy ; pregnancy-associated melanoma ; outcomes ; sentinel node ; survival ; young
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：74
• 期：4
• 页码：731-738
• 全文大小：564 K

文摘

Melanoma is the fifth most common cancer in the United States, with recent reports indicating increasing incidence among young women.

Objective

This study sought to investigate histopathology, staging, risk factors, and outcomes of cutaneous melanoma in women younger than 50 years.

Methods

All female patients aged up to 49 years with biopsy-proven diagnosis of melanoma between 1988 and 2012 were included. Patients with a follow-up of less than 2 years were excluded.

Results

A total of 462 patients were identified, with mean age of 34.7 years. Invasive melanoma was less common in women 19 years of age or younger (P < .0008). Positive sentinel node status (P < .008), recurrence rates, metastatic disease (P < .001), and death rates (P < .008) were higher for women ages 40 to 49 years. The 41 patients with a pregnancy-associated melanoma had a significantly worse prognosis in comparison with a control group of nonpregnant patients, with a 9-fold increase in recurrence (P < .001), 7-fold increase in metastasis (P = .03) and 5-fold increase in mortality (P = .06).

Limitations

This was a retrospective study.

Conclusion

The increasing incidence of melanoma for women younger than 50 years suggests that regular skin checks and self-examinations are warranted. In addition, in women given the diagnosis of melanoma during or within 1 year after childbirth, regular follow-up and monitoring for recurrence are recommended.