Clinicopathological features of and risk factors for multiple primary melanomas Journal Article

Authors: Ferrone, C. R.; Porat, L. B.; Panageas, K. S.; Berwick, M.; Halpern, A. C.; Patel, A.; Coit, D. G.
Article Title: Clinicopathological features of and risk factors for multiple primary melanomas
Abstract: Context: The incidence of multiple primary melanomas ranges from 1.3% to 8.0% in large retrospective reviews; however, the impact of certain risk factors is not understood. Objectives: To determine the incidence of multiple primary melanomas (MPM) from a prospective, single-institution, multidisciplinary database, and to describe the clinical and pathological characteristics and risk factors specific to these patients. Design and Setting: Review of a prospectively maintained database at Memorial Sloan-Kettering Cancer Center in New York, NY. Patients: A total of 4484 patients diagnosed with a first primary melanoma between January 1, 1996, and December 31, 2002. Main Outcome Measures: Incidence of and risk factors for MPM. Results: Three hundred eighty-five patients (8.6%) had 2 or more primary melanomas, with an average of 2.3 melanomas per MPM patient. Seventy-eight percent had 2 primary melanomas. For 74% of patients, the initial melanoma was the thickest tumor. Fifty-nine percent presented with their second primary tumor within 1 year. Twenty-one percent of MPM patients had a positive family history of melanoma compared with only 12% of patients with a single primary melanoma (SPM) (P<.001). Thirty-eight percent of MPM patients had dysplastic nevi compared with 18% of SPM patients (P<.001). The estimated cumulative 5-year risk of a second primary tumor for the entire cohort was 11.4%, with almost half of that risk occurring within the first year. For patients with a positive family history or dysplastic nevi, the estimated 5-year risk of MPM was significantly higher at 19.1% and 23.7%, respectively. The most striking increase in incidence for the MPM population was seen for development of a third primary melanoma from the time of second primary melanoma, which was 15.6% at 1 year and 30.9% at 5 years. Conclusions: The incidence of MPM is increased in patients with a positive family history and/or dysplastic nevi. These patients should undergo intensive dermatologic screening and should consider genetic testing. ©2005 American Medical Association. All rights reserved.
Keywords: adolescent; adult; child; controlled study; aged; aged, 80 and over; child, preschool; middle aged; major clinical study; clinical feature; review; cancer risk; prospective study; melanoma; cohort studies; skin neoplasms; incidence; cohort analysis; risk factors; data base; risk factor; infant; family history; neoplasms, second primary; neoplasms, multiple primary
Journal Title: JAMA - Journal of the American Medical Association
Volume: 294
Issue: 13
ISSN: 0098-7484
Publisher: American Medical Association  
Date Published: 2005-10-05
Start Page: 1647
End Page: 1654
Language: English
DOI: 10.1001/jama.294.13.1647
PUBMED: 16204664
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 55" - "Export Date: 24 October 2012" - "CODEN: JAMAA" - "Source: Scopus"
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MSK Authors
  1. Cristina Ferrone
    32 Ferrone
  2. Allan C Halpern
    305 Halpern
  3. Marianne Berwick
    120 Berwick
  4. Katherine S Panageas
    331 Panageas
  5. Daniel Coit
    424 Coit
  6. Ami Patel
    24 Patel