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Melanoma and Pregnancy: is the controversy over?
STEVEN RUEDA MD
ALEJANDRA TELLEZ MD
RUZIKA CONIC
NATASHA MESINKOVSKA
BRIAN GASTMAN MD
CLEVELAND CLINIC FOUNDATION
2015-03-15
Presenter: STEVEN RUEDA MD
Affidavit:
This represents the work of the resident in its majority
Director Name: STEVEN L BERNARD MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
INTRODUCTION-
Melanoma is the fifth most common cancer in the United States and continues to increase faster than any other preventable cancer. Females younger than 40 years are at double the risk compared to males of the same age. This single-center retrospective case-control study assessed outcomes of cutaneous melanomas developing in women of 49 years of age and younger to identify characteristics that lead to increased risk of disease.
METHODS –
Woman with biopsy proven cutaneous melanoma between 10 to 49 years of age were retrospectively identified from 1998 to 2012 in institutional database. Demographics, reproductive history, tumor characteristics were collected. Univariate and Multivariate statistical analysis compared rates of mortality, recurrence, metastatic disease across age groups, stage, and pregnancy within one year of diagnosis.
RESULTS –
A total of 467 patients were selected for review. Melanoma mortality rates were higher in group with history of pregnancy within one year of diagnosis compared to non-pregnant group (20% vs 10.3%; p=0.05). There was also higher rate of metastatic disease in the pregnancy group (25% vs 12.7%; p=0.03).Patients with history of pregnancy within 1 year of diagnosis had associated five-fold increased odds of melanoma specific mortality, six-fold increased odds of distant metastatic disease, and nine-fold increased odds of local melanoma recurrence compared to those with no recent pregnancy (OR 5.1, OR 6.7, OR 9.2; p<0.01)
CONCLUSIONS –
Patients with history of pregnancy within 1 year of melanoma diagnosis represent a population at increased risk of mortality, recurrence, and metastasis that may benefit from intensified surveillance protocols.
