Management of Melanoma during Pregnancy: A Case Series of 11 Women Treated at NYU Langone Health

Abstract

<b><i>Objectives:</i></b> Melanoma is one of the most common malignancies diagnosed during pregnancy. This study examined the impact of pregnancy on management decisions of melanoma patients treated at NYU Langone Health (NYULH). <b><i>Methods:</i></b> We analyzed data for patients who were pregnant at initial or recurrent melanoma diagnosis at NYULH from 2012 to 2019 with prospective protocol-driven follow-up. <b><i>Results:</i></b> Of the 900 female patients accrued during this period, 11 women in the childbearing range were pregnant at melanoma diagnosis. Six patients presented with early (stage 0 or I) disease and five with advanced (stage III or IV) melanoma. Women with early stage disease had normal deliveries and minimal changes to their treatment timeline and regimen. However, patients with more advanced stage disease opted for either termination of the pregnancy or early delivery and altered treatment timelines because of pregnancy. <b><i>Conclusion:</i></b> Both melanoma stage and gestational age at diagnosis contribute to the differences in the therapeutic management of melanoma in pregnant women. Given the complexity and variety of each case of melanoma during pregnancy, informed discussion between patients and physicians allows for individualized treatment plans that address each patient’s unique situation.

Melanoma During Pregnancy as a Complicated Medical Problem

“…In the case of the second group of patients (advanced stage of the disease), the patients decided to abort the pregnancy or give birth early. Pregnancy in this case significantly affected the treatment by directly postponing it 81 . According to research, aiming for delivery after 37 weeks of pregnancy should be a priority whenever possible.…”

“…79 There are many positions regarding both the treatment itself and the pregnancy of patients, so there is still a need for further research into the treatment of melanoma in pregnancy (Table 2). 80,81…”

“…Pregnancy in this case significantly affected the treatment by directly postponing it. 81 According to research, aiming for delivery after 37 weeks of pregnancy should be a priority whenever possible. However, it is important to keep in mind that accelerated maternal treatment associated with premature…”