Malignant melanoma in pregnancy. A population-based evaluation

Area of Science:

• Oncology
• Dermatology
• Obstetrics & Gynecology

Background:

• Controversy exists regarding hormonal factors and malignant melanoma outcomes in women.
• Previous reports suggested a worse prognosis for pregnant women with melanoma.
• This study investigates the correlation between pregnancy and melanoma prognosis.

Purpose of the Study:

• To determine if pregnancy influences the stage, tumor characteristics, or survival of women diagnosed with malignant melanoma.
• To compare outcomes of pregnancy-associated melanoma with those of non-pregnant women.

Main Methods:

• Utilized California maternal/neonatal discharge records (1991-1999) linked to the California Cancer Registry.
• Identified 412 women with melanoma diagnosed during or within 1 year of pregnancy (> or = 20 weeks gestation).
• Compared these women with age-matched, non-pregnant controls.

Main Results:

• No significant differences in disease stage (localized melanoma: 82.0% vs. 81.9%) or tumor thickness (mean: 0.77-0.90 mm) between groups.
• Pregnancy did not impact survival in a multivariate analysis controlling for age, race, stage, and thickness.
• Equivalent lymph node assessment and positivity were observed; maternal/neonatal outcomes were similar to pregnant controls without malignancy.

Conclusions:

• This population-based study found no evidence that pregnancy worsens melanoma stage, tumor thickness, lymph node metastasis, or survival.
• Outcomes for localized melanoma associated with pregnancy were excellent.
• Maternal and neonatal outcomes were comparable between pregnant women with and without melanoma.