Epidemiology of Lentigo Maligna and Lentigo Maligna Melanoma in the Netherlands, 1989–2013

Greveling, Karin; Wakkee, Marlies; Nijsten, Tamar; Bos, R.R. van den; Hollestein, Loes

doi:10.1016/j.jid.2016.06.014

Cited by 55 publications

(49 citation statements)

References 35 publications

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“…LMMs are usually thin lesions without aggressive growth patterns, explaining why they show excellent survival rates and high prevalence of regression [2, 15]. Nevertheless, they preserve the potential to acquire metastatic characteristics leading to poorer prognosis [10].…”

Section: Discussionmentioning

confidence: 99%

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A Retrospective Cohort Study on Patients with Lentigo Maligna Melanoma

et al. 2019

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Background: More epidemiological data about lentigo maligna melanoma (LMM) are required to define follow-up guidelines. The study focused on recurrence, progression, and overall survival of LMM managed with primary wide local excision. Methods: In a 23-year retrospective study (1994 to 2016), a cohort of patients with LMM was evaluated by collecting data about the tumor location, the Breslow depth, the presence of ulceration, and patients’ age and sex. Local recurrences, locoregional and distant metastases, and disease-free and overall survival were additionally assessed. Results: Overall, 150 cases (84 male, 66 female, mean age 71.3 ± 11.3 years) of single, localized, primary LMM with a mean follow-up of 6.6 ± 4.4 years were included. A total of 33 (22.2%) patients underwent sentinel lymph node biopsy (SLNB) during surgical excision. However, positive SLNB was detected in none of them. The multivariable Cox analysis indicated that age of diagnosis and male gender significantly influenced the overall survival, while a shorter disease-free survival could be correlated with a greater Breslow thickness. The metastatic potential turned out to be low, entailing 7 deaths in the context of the LMM. Conclusion: Male gender, age over 70 at diagnosis, and a Breslow thickness greater than 0.75 mm were associated with a statistically significant decrease in overall disease-free survival in the current study. The results of the study confirm the favorable outcome of LMM. However, diagnosed patients should undertake regular follow-ups. The intensity of follow-up in these patients can be individualized based on the probability of recurrence/metastasis and overall survival. Furthermore, the study showed that SLNB might not be a necessary staging procedure in patients with LMM.

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Section: Discussionmentioning

confidence: 99%

“…Lentigo maligna melanoma (LMM) is one of the four subtypes of cutaneous melanomas representing the third most common type with 4–15% [1, 2]. The other three principal subtypes are superficial spreading, nodular, and acral lentiginous melanomas [3].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Cohort Study on Patients with Lentigo Maligna Melanoma

et al. 2019

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“…In northern Europe, the Netherlands, Greveling et al . studied the incidence trends in LM/LMM over a period of 25 years (1989–2013).…”

Section: Discussionmentioning

confidence: 99%

Increasing incidence of lentigo maligna and lentigo maligna melanoma in Catalonia

et al. 2018

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Background Recent epidemiological studies suggest that past data where superficial spreading melanoma was by far the most common subtype of melanoma may not reflect current patterns of sun exposure or other risk factors more involved in other subtypes of melanoma as lentigo maligna (LM) or lentigo maligna melanoma (LMM). Methods In order to measure the current situation in our country, all cases of LM and LMM diagnosed in 23 hospitals in Catalonia, from 2000 to 2007, were recorded. Results Although for the global period LM/LMM represented only 8.4% of cases, an increasing trend in this percentage was observed throughout the study period (from 6.9% [27 cases] in 2000 to 13.1% [94 cases] in 2007). Also, an increasing incidence of LM/LMM was observed, especially in chronically sun‐exposed areas (85.5% involving the head and neck region). During the 8 years of the registry, the mean Breslow thickness of LMM remained stable. However, the increase in the number of LM (in situ) cases was significantly higher than the increase of the invasive ones. Conclusions An important observation from this data is that aging of population and current sun exposure patterns could keep increasing the incidence of LM/LMM, which may become an important public healthcare problem, over the other histological subtypes. In order to establish primary or secondary preventive measures to the LM/LMM risk‐population, it is imperative to highlight the importance of chronic sun damage as a melanoma risk factor, and not only sunburn, most commonly addressed in melanoma prevention campaigns.

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“…If the diagnosis of LM is made at the age of 65, the lifetime risk of developing LMM would be 2.2% without treatment . A recent Dutch study showed that the risk of progression of a LM to LMM is 1.8–2.2% lifetime risk …”

Section: Introductionmentioning

confidence: 99%

A systematic review on the role of imiquimod in lentigo maligna and lentigo maligna melanoma: need for standardization of treatment schedule and outcome measures

Tio¹,

Woude

Prinsen

et al. 2017

Acad Dermatol Venereol

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Lentigo maligna (LM) is an in situ variant of melanoma. Our objective was to systematically review clinical and histological clearance and recurrence rates of imiquimod treatment of LM with emphasis on progression to lentigo maligna melanoma (LMM). PubMed, EMBASE and the Cochrane library were searched from inception to May 2015. Articles were included if they described histologically proven LM treated with imiquimod 5% monotherapy or combined with another topical therapy. Analysed outcomes were clinical and histological clearance, recurrence rates and number of LMM. The quality was assessed using the GRADE-like checklist, and results were reported according to the PRISMA Statement. Twenty-six case reports, 11 retrospective studies, three prospective studies and one randomized controlled trial were included. One case report of poor quality was excluded. Complete clinical clearance was seen in 369 of 471 patients (78.3%). Histological clearance was present in 285 of 370 (77%) patients. LMM was diagnosed in nine (1.8%) patients 3.9 months (range 0-11 months) post-treatment. Univariate multinominal logistic regression showed that 6-7 applications/week had a 6.47 greater odds (P = 0.017) of resulting in complete clinical clearance compared to 1-4 applications/week. An intensity of 6-7 applications/week showed a 8.85 greater odds (P = 0.003) of resulting in histological clearance compared to 1-4 applications. Applying imiquimod >60 times during a treatment period of 12 weeks (range 4-36) showed a 7.75 greater odds (P = 0.001) of resulting in histological clearance compared to <60 total applications. In conclusion, a treatment schedule using imiquimod 6-7 applications per week, with at least 60 applications, shows the greatest odds of complete clinical and histological clearance of LM. Imiquimod is an option for patients unfit for or not willing to undergo surgery or radiotherapy. Nine cases of LM progressed to LMM shortly after treatment. Our hypothesis is that these LMM may have been present before starting imiquimod.

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Epidemiology of Lentigo Maligna and Lentigo Maligna Melanoma in the Netherlands, 1989–2013

Cited by 55 publications

References 35 publications

A Retrospective Cohort Study on Patients with Lentigo Maligna Melanoma

A Retrospective Cohort Study on Patients with Lentigo Maligna Melanoma

Increasing incidence of lentigo maligna and lentigo maligna melanoma in Catalonia

A systematic review on the role of imiquimod in lentigo maligna and lentigo maligna melanoma: need for standardization of treatment schedule and outcome measures

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