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Reduced disease-specific survival following a diagnosis of multiple primary cutaneous malignant melanomas-a nationwide, population-based study
Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
Karolinska University Hospital, Sweden.
Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
2017 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 141, no 11, 2243-2252 p.Article in journal (Refereed) Published
Abstract [en]

Outcome data comparing patients with multiple primary invasive cutaneous malignant melanomas (MPMs) to single primary invasive cutaneous malignant melanomas (SPMs) show conflicting results. We have analyzed differences in disease-specific survival between these patients in a nationwide population-based setting. From the Swedish Melanoma Register, 27,235 patients were identified with a first invasive cutaneous malignant melanoma (CMM) between 1990 and 2007, followed-up through 2013. Of these, 700 patients developed MPMs. Cox proportional hazard regression was used for adjusted cause-specific hazard ratios (HRs). An interval of amp;lt;= 5 years between CMM diagnoses was significantly correlated to a decreased CMM-specific survival in Stage I-II MPM-vs. SPM-patients (HR 1.32; 95% CI 1.04-1.67; p=0.02). MPM-patients with longer time interval between diagnoses experienced similar risk of CMM-death as SPM-patients. The risk of CMM-death increased by almost 50% above the expected outcome according to stage of the index CMM by the diagnosis of a second CMM (HR 1.48; 95% CI 1.19-1.85; p amp;lt; 0.001). MPM vs. SPM-patients had a worse outcome (HR 1.38; 95% CI 1.05-1.83; p=0.001). This emphasizes the importance of prevention efforts in SPM-patients to decrease the risk of subsequent CMMs and has implications for more vigilant follow-up in MPM-patients.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 141, no 11, 2243-2252 p.
Keyword [en]
cutaneous malignant melanoma; multiple melanomas; disease-specific survival; interval-time; population-based
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-142134DOI: 10.1002/ijc.30925ISI: 000412473600008PubMedID: 28799271OAI: oai:DiVA.org:liu-142134DiVA: diva2:1151723
Note

Funding Agencies|Swedish Cancer Society [CAN 2010/225, CAN 2011/883]; Radiumhemmet Research Funds [124083, 124092]; Sigurd and Elsa Goljes Memorial Foundation [LA2016-0389]; KI funds [2016fobi50190]

Available from: 2017-10-24 Created: 2017-10-24 Last updated: 2017-10-24

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Lyth, Johan
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesResearch & Development Unit in Local Health Care
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