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Clinicopathologic Features of Incident and Subsequent Tumors in Patients with Multiple Primary Cutaneous Melanomas

  • Melanomas
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Annals of Surgical Oncology Aims and scope Submit manuscript

An Erratum to this article was published on 11 September 2012

Abstract

Background

0.6–12.7% of patients with primary cutaneous melanoma will develop additional melanomas. Pathologic features of tumors in patients with multiple primary cutaneous melanomas have not been well described. In this large, international, multicenter, case–control study, we compared the clinicopathologic features of a subsequent melanoma with the preceding (usually the first) melanoma in patients with multiple primary cutaneous melanomas, and with those of melanomas in patients with single primary cutaneous melanomas.

Methods

Multiple primary melanoma (cases) and single primary invasive melanoma (controls) patients from the Genes, Environment and Melanoma (GEM) study were included if their tumors were available for pathologic review and confirmed as melanoma. Clinicopathologic characteristics of invasive subsequent and first melanomas in cases and invasive single melanomas in controls were compared.

Results

A total of 473 pairs comprising a subsequent and a first melanoma and 1,989 single melanomas were reviewed. Forward stepwise regression modeling in 395 pairs with complete data showed that, compared with first melanomas, subsequent melanomas were more commonly contiguous with a dysplastic nevus, more prevalent on the head/neck and legs than other sites, and thinner. Compared with single primary melanomas, subsequent melanomas were more likely to be associated with a contiguous dysplastic nevus, more prevalent on the head/neck and legs, and thinner. The same differences were observed when subsequent melanomas were compared with single melanomas. First melanomas were more likely than single melanomas to have associated solar elastosis and no observed mitoses.

Conclusions

Thinner subsequent than first melanomas suggest earlier diagnosis, perhaps due to closer clinical scrutiny. The association of subsequent melanomas with dysplastic nevi is consistent with the latter being risk factors or risk markers for melanoma.

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Acknowledgment

This work is supported by the following NIH/NCI grants: U01 CA83180, R01 CA112425, R01 CA112243, and R01 CA112243-05S1. Professor Scolyer is a Cancer Institute New South Wales Clinical Research Fellow.

Author information

Authors and Affiliations

  1. Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia

    Rajmohan Murali MBBS, MD, FRCPA & Richard A. Scolyer MBBS, MD, FRCPA, FRCPath

  2. Melanoma Institute Australia, Sydney, Australia

    Rajmohan Murali MBBS, MD, FRCPA, Anne Kricker PhD, Richard A. Scolyer MBBS, MD, FRCPA, FRCPath & Bruce K. Armstrong AM, DPhil, FRACP, FAFPHM, FAA

  3. Discipline of Pathology, The University of Sydney, Sydney, Australia

    Rajmohan Murali MBBS, MD, FRCPA & Richard A. Scolyer MBBS, MD, FRCPA, FRCPath

  4. School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia

    Chris Goumas MPH, Anne Kricker PhD & Bruce K. Armstrong AM, DPhil, FRACP, FAFPHM, FAA

  5. Women’s College Hospital, Toronto, ON, Canada

    Lynn From MD, FRCPC

  6. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA

    Klaus J. Busam MD

  7. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Colin B. Begg PhD & Irene Orlow PhD

  8. Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia

    Terence Dwyer MD, MPH

  9. Division of Molecular Medicine & Genetics, University of Michigan, Ann Arbor, MI, USA

    Stephen B. Gruber MD, PhD, MPH

  10. University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Peter A. Kanetsky PhD, MPH

  11. CPO-Registro Tumori Piemonte, via San Francesco da Paola, Turin, Italy

    Stefano Rosso PhD

  12. Department of Dermatology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA

    Nancy E. Thomas MD, PhD

  13. Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM, USA

    Marianne Berwick PhD, MPH

  14. Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Rajmohan Murali MBBS, MD, FRCPA

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  1. Rajmohan Murali MBBS, MD, FRCPA
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  2. Chris Goumas MPH
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  3. Anne Kricker PhD
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  4. Lynn From MD, FRCPC
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  6. Colin B. Begg PhD
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  7. Terence Dwyer MD, MPH
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  14. Richard A. Scolyer MBBS, MD, FRCPA, FRCPath
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  15. Bruce K. Armstrong AM, DPhil, FRACP, FAFPHM, FAA
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For the GEM Study Group

Corresponding author

Correspondence to Rajmohan Murali MBBS, MD, FRCPA.

Additional information

This study is conducted for the GEM Study Group. The list of GEM Study Group who conducted in this study are given in Appendix.

Appendix

Appendix

The following persons conducted in this study: Marianne Berwick (PI, University of New Mexico), Memorial Sloan-Kettering Cancer Center, New York, NY, USA: Colin Begg (Co-PI), Irene Orlow (Co-Investigator), Urvi Mujumdar (Project Coordinator), Klaus Busam (Dermatopathologist), Pampa Roy (Laboratory Technician). Study Centers: The University of Sydney and The Cancer Council New South Wales, Sydney (Australia): Bruce Armstrong (PI), Anne Kricker (co-PI), Melisa Litchfield (Study Coordinator). Menzies Research Institute, University of Tasmania, Hobart (Australia): Terence Dwyer (PI, currently at the Murdoch Childrens Research Institute, Melbourne, Victoria), Paul Tucker (Dermatopathologist), Alison Venn (co-Investigator), Nicola Stephens (Study Coordinator). British Columbia Cancer Agency, Vancouver (Canada): Richard Gallagher (PI), Teresa Switzer (Coordinator). Cancer Care Ontario, Toronto (Canada): Loraine Marrett (PI), Elizabeth Theis (Co-Investigator), Lynn From (Dermatopathologist), Noori Chowdhury (Coordinator), Louise Vanasse (Coordinator). Centro per la Prevenzione Oncologia Torino, Piemonte (Italy): Stefano Rosso (PI), Roberto Zanetti (co-PI), Carlotta Sacerdote (Coordinator). University of California, Irvine (USA): Hoda Anton-Culver (PI), Nancy Leighton (Coordinator). University of Michigan, Ann Arbor (USA): Stephen Gruber (PI), Joanne Jeter (Coordinator). New Jersey Department of Health and Senior Services, Trenton (USA): Judith Klotz (PI), Homer Wilcox (Co-PI), Helen Weiss (Coordinator). University of North Carolina, Chapel Hill (USA): Robert Millikan (PI), Nancy Thomas (Co-Investigator), Dianne Mattingly (Coordinator), Jon Player (Laboratory Technician). University of Pennsylvania, Philadelphia, PA (USA): Timothy Rebbeck (PI), Peter Kanetsky (Co-Investigator), Amy Walker (Laboratory Manager), Saarene Panossian (Laboratory Technician). Consultants: Julia Lee Taylor and Sasha Madronich, National Centre for Atmospheric Research, Boulder, Colorado (USA).

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Murali, R., Goumas, C., Kricker, A. et al. Clinicopathologic Features of Incident and Subsequent Tumors in Patients with Multiple Primary Cutaneous Melanomas. Ann Surg Oncol 19, 1024–1033 (2012). https://doi.org/10.1245/s10434-011-2058-8

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