Association of multiple primary melanomas with malignancy risk: a population-based analysis of the Surveillance, Epidemiology, and End Results Program database from 1973-2014. Journal of the American Academy of Dermatology Cai, E. D., Swetter, S. M., Sarin, K. Y. 2018


BACKGROUND: Genetic and environmental risk factors have been associated with the development of multiple primary melanomas (MPM). We hypothesized that individuals with MPM may have increased predisposition to developing internal malignancies.OBJECTIVE: To identify the risk of subsequent malignancies in MPM patients.METHODS: Multiple primary standardized incidence ratios were analyzed for individuals with =1, =2 and =3 primary melanomas (PM) in the SEER database from 1973-2014.RESULTS: 223,799 individuals with =1, 19,709 with =2 and 3,995 with =3 PM were identified. Risks of subsequent internal malignancy increased with number of PM, with observed to expected (O/E) ratios of 0.99, 1.14, and 1.23 (p<0.05) for patients with at least one, two and three PM respectively. Internal malignancy was higher in younger MPM patients and those with superficial spreading melanoma. The most common malignancies amongst MPM patients include breast, prostate, thyroid, soft tissue, brain, kidney, non-Hodgkin's lymphoma, and chronic lymphocytic leukemia. Risk of subsequent cutaneous melanoma increased with O/E ratios of 8.09, to 22.52, to 41.03 (p<0.05) respectively.LIMITATIONS: SEER records limited information about pigmentation phenotypes, histology, and treatments.CONCLUSION: Patients with MPM have increased risk of subsequent internal and cutaneous malignancies and may benefit from tight adherence to age-specific cancer screening.

View details for PubMedID 30287320