Increased thickness of pregnancy-associated melanoma

Travers, Robin; Sober, Arthur J.; Barnhill, R. L.; Mihm, Martín C.; Duncan, Lyn M.

doi:10.1097/00008390-199303000-00150

Cited by 34 publications

(47 citation statements)

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“…Studies on the influence of pregnancy in melanoma have been inconclusive and clinical trials of antiestrogens have almost uniformly disappointing results. 32,33 Further research is necessary to elucidate the complex mechanisms that underline the gender-related differences in the outcome of melanoma with the hope that the survival advantage of women might be expanded to include the entire melanoma population.…”

Section: Discussionmentioning

confidence: 99%

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

Lasithiotakis¹,

Leiter²,

Meier³

et al. 2008

Cancer

230

178

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BACKGROUNDThe aim was to identify age‐ related and gender‐related differences in the clinical presentation and outcome of patients with primary cutaneous melanoma (CM).METHODSA total of 4785 CM patients without clinical evidence of metastasis diagnosed during the period 1976–2001 in southern Germany included in the analysis. Kaplan‐Meier analyses were performed to estimate and to compare disease‐specific survival (DSS) and survival after first recurrence (SAR). The Cox proportional hazards model was used to evaluate the effect of multiple variables on DSS and SAR.RESULTSIncreasing age and male gender were independently associated with thicker tumors (>2 mm) and histologic ulceration (P < .001). Patients older than 65 years had lower 10‐year DSS than younger patients (81.8% vs 88.4%, P < .001) and this difference was more pronounced in women (P < .001) than in men (P = .06). Males had lower 10‐year DSS than females (83.5% vs 88.5%, P < .001) but this difference did not reach statistical significance in patients older than 65 years (P = .162). In multivariate analysis adjusted for tumor thickness, ulceration, anatomic site, histologic subtype, DSS, site of first recurrence, time trend, sentinel lymph node status, age, and gender were independent predictors of DSS and SAR (P < .05).CONCLUSIONSOlder age and male gender are associated with prognostically unfavorable primary CM. Expansion of current preventive strategies to target these subgroups is warranted. Moreover, age and gender are independent predictors of the outcome of CM patients. Females have a better prognosis than males but this difference disappears after the age of 65. Younger patients have a more favorable prognosis than older patients, a difference more pronounced in women. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Age and gender are significant independent predictors of survival in primary cutaneous melanoma

Lasithiotakis¹,

Leiter²,

Meier³

et al. 2008

Cancer

230

178

View full text Add to dashboard Cite

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“…One point on which studies of melanoma in pregnancy do agree is that pregnancy-associated melanomas are often significantly thicker than that of non-pregnancy-associated tumours. Intriguingly these thicker tumours are not necessarily associated with a less favourable prognosis than tumours arising in a non-pregnant woman (Travers et al, 1995).…”

mentioning

confidence: 93%

Investigation of female survival benefit in metastatic melanoma

et al. 1999

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Summary Epidemiological studies show female survival benefit in advanced metastatic melanoma. In investigating a possible mechanism for this female survival benefit, we have previously reported that the female steroid 17β-oestradiol significantly reduces invasion of a human melanoma cell line (A375-SM cells) and ocular melanoma cells through fibronectin. Neither cell type was found to possess oestrogen receptor-α. The aim of the current study was to obtain further information on the extent to which progression of cutaneous melanoma might be sex steroid sensitive by (a) examining the relationship between circulating sex steroids, sex hormone binding globulin and disease progression; (b) examining the relationship between sex steroid structure and the ability of steroids to reduce invasion of a melanoma cell line in vitro; and (c) examining the effects of sex steroids on proliferation of these cells in vitro. We report a significant reduction in circulating oestrone with disease progression in male but not female patients. Examining steroids for their ability to inhibit invasion of A375-SM cells through fibronectin in vitro, oestrogenic compounds (17β-oestradiol and oestrone) were found to inhibit invasion; in this respect, oestrone was approximately 50 times more potent than 17β-oestradiol; steroids lacking the benzene ring structure did not inhibit invasion, indeed dehydroepiandrosterone (DHEA) which acts as a precursor to androgenic steroids significantly enhanced invasion. Proliferation of A375-SM cells was unaffected by 17β-oestradiol, oestrone or dihydrotestosterone when cells were cultured on plastic; in contrast, all three steroids induced modest proliferation of cells when grown on fibronectin with dihydrotestosterone the most mitogenic of the three steroids. These data are consistent with sex steroids playing a role in melanoma progression.Keywords: melanoma; invasion; oestrogen; testosterone; oestrogen receptor-β 2025British Journal of Cancer (1999) 80(12), 2025-2033 © 1999 Cancer Research Campaign Article no. bjoc.1999 Received 8 September 1998 Revised 19 February 1999 Accepted 23 February 1999 Correspondence to: S Mac Neil A375-SM cell line used in this study did not possess classical oestrogen receptors (oestrogen receptor-α) nor did the majority of melanoma tumours which we investigated (Dewhurst et al, 1997, and Miller et al, 1997, respectively).In the current study we have continued investigations of sex steroid status and tumour progression for a cohort of patients with advanced metastatic disease versus appropriately aged and sexmatched controls and we have investigated to what extent the antiinvasive effect of 17β-oestradiol is specific to oestrogenic steroids.We report a modest reduction in sex hormone binding globulin and oestrone with disease progression in male but not female patients. Examining a range of steroids for anti-invasive activity, we found oestrogenic compounds (17β-oestradiol and oestrone) to inhibit invasion; steroids lacking the benzene ring structure did not inhibit invas...

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“…Each change of existing or appearance of new nevus should be followed carefully by gynecologist at each patient visit and biopsy should be indicated in case of each suspected lesion. A number of studies report that women diagnosed with melanoma during pregnancy present thicker tumors (Lens et al, 2004, MacKie et al, 1991, Travers et al, 1995. In Lens study tumor tickness was 1.28 mm in pregnant and 1.07 mm in non-pregnant patients.…”

Section: Problems In Pregnancymentioning

confidence: 92%

“…In the study of Slingluff et al (Slingluff et al, 1990) there was no difference in the survival time, but pregnant patients were presented with a larger number of involved lymph nodes (39% versus 26%, p=0.053) at diagnosis, lymph node metastases appeared in shorter interval after the diagnosis of stage I disease (p=0.021), and shorter disease free survival (DFS). The results of following studies have not reported difference in survival among pregnant patients (MacKie et al, 1991;Stein et al, 1990;Driscoll et al, 1993;Travers et al, 1995;Grin et al, 1996;Daryanani et al, 2003), but in some a caution has been stressed to the diagnosis of thicker melanoma in pregnancy (MacKie et al, 1991;Travers et al, 1995). In already mentioned Lens et al study (Lens et al, 2004) (Figure 2.…”

Section: Impact Of Pregnancy To Melanoma Prognosismentioning

confidence: 98%