Riesgo de melanoma y lunares

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Published in Dermatology
Journal Scan / Research · February 21, 2019
Cutaneous Nevi and Risk of Melanoma Death in Women and Men
Journal of the American Academy of Dermatology
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This prospective study examined the association between the number of common nevi and the risk of melanoma death. Of 2452 confirmed melanoma cases, 196 deaths due to melanoma were identified. Overall risk analyses found that a higher number of nevi was significantly associated with risk of melanoma death (Ptrend=.003 in women and <.0001 in men), with the hazard ratio for three or more nevi compared with no nevi of 2.49 for women and 3.97 for men. In the analysis of melanoma cases only, a higher number of nevi was independently associated with melanoma death in men (HR for ≥3 nevi, 1.89) but not in women. Nevi count was positively
934081486)associated with Breslow thickness in men only (Ptrend=.01).
These findings suggest that a high nevi count may serve as an independent
cticeupdatep) rognostic factor for death due to melanoma, particularly in men.
– InYoung Kim, MD, PhD

Dermatology
Written by Laura Ferris MD, PhD


This study is an analysis of melanoma outcomes using two large cohort studies of health professionals. Data for women were obtained from the Nurses' Health Study (NHS) and data for men were obtained from the Health Professionals Follow-Up Study (HPFS). The authors show a relationship between nevus count (three or more nevi on the arms was considered to be a high nevus count). Death from melanoma in the entire population was higher in both men and women among those with a high nevus count than among those who did not meet the criteria for having a high nevus count. This is consistent with data showing that a higher number of common or atypical nevi is associated with an increased risk of melanoma (and thus, an increased risk of death from melanoma).
The authors also looked at the risk of death among those patients with melanoma and found that a high nevus count was associated with an increased risk of death among men, but not women, with melanoma. Interestingly, other studies have found that a low nevus count is actually associated with more aggressive melanomas, later age at diagnosis with melanoma, and an increased risk of death from melanoma.1 It is not clear why these studies have different findings, but this may be in part attributable to differences in the patient populations, methods for collecting melanoma diagnoses and outcomes, and criteria used to determine high versus low nevus count. Another important consideration in reviewing any data from the NHS and HPFS is that the patients in these cohorts are primarily nurses and physicians and thus will differ from patients in most cohorts in their medical knowledge and outcomes reporting and also likely in their health behaviors including, possibly, ultraviolet light exposure.

Reference

1. Ribero S, Davies JR, Requena C, et al. High nevus counts confer a favorable prognosis in melanoma patients. Int J Cancer. 2015;137(7):1691- 1698.

Abstract

This abstract is available on the publisher's site.

BACKGROUND
It was unclear whether increased number of common nevi (moles) predicts melanoma death.
OBJECTIVE
We prospectively examined the association between number of common nevi and risk of melanoma death METHODS: Our study was based on the Nurses' Health Study (n=77,288 women) and Health Professionals Follow-up Study (n=32,455 men). Number of moles with ≥3 mm diameter on the upper extremity was asked in 1986 and was re-classified into three categories (none, 1-2, or ≥3) based on data distribution.
RESULTS
During follow-up (1986-2012), 2,452 melanoma cases were pathologically confirmed, among whom we identified 196 deaths due to melanoma. Increased number of nevi was associated with melanoma death; the hazard ratio (HR) for ≥3 nevi compared with no nevi was 2.49 [95% confidence interval(CI): 1.50-4.12] for women and 3.97 (95%CI: 2.54-6.22) for men. Among melanoma cases, increased number of nevi was associated with melanoma death in men (≥3 nevi: HR=1.89, 95%CI: 1.17-3.05), but not in women. Similarly, number of nevi was positively associated with Breslow thickness in men only (Ptrend=0.01).
LIMITATIONS
This is an epidemiologic study without examination into mechanisms.
CONCLUSIONS
Increased number of cutaneous nevi was significantly associated with melanoma death. High nevi count may serve as an independent prognostic factor, which predicts the risk of melanoma death particularly among male melanoma cases.

Copyright © 2019 Elsevier Inc. All rights reserved.

Article Citation

Journal of the American Academy of Dermatology
Cutaneous Nevi and Risk of Melanoma Death in Women and Men: A Prospective Study

J Am Acad Dermatol 2019 Jan 10;[EPub Ahead of Print], WQ Li, E Cho, MA Weinstock, S Li, MJ Stampfer, AA Qureshi
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
http://www.ncbi.nlm.nih.gov/pubmed/30639880
(https://dx.doi.org/10.1016/j.jaad.2018.12.058)

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