Brady Mary S, Noce Nikki S
J Clin Aesthet Dermatol. 2010 Mar;3(3):22-8.
There exists a strong belief among physicians and the lay public that pregnancy adversely affects survival in patients with melanoma. The authors asked if there was any evidence to support this in patients with clinically localized disease.
The authors reviewed the published literature on MEDLINE.
The authors found no compelling evidence in the literature that pregnancy has a negative impact on survival in patients with clinically localized cutaneous melanoma. Two recent population-based studies reported no negative impact of pregnancy on survival when pregnant melanoma patients were compared to nonpregnant gender-matched controls. A small increased risk of cause-specific death was noted in a recent population-based study, though this effect was small (HR, 1.52, p=0.47) and pregnant patients were more likely to have axial primary sites, which are associated with a poorer outcome.
There is no compelling evidence that pregnancy adversely affects outcome in melanoma patients who have clinically localized disease. Continuing to recommend a delay in childbearing for these patients is not supported by the published medical literature.
医生和普通大众都坚信，怀孕会对黑色素瘤患者的生存产生不利影响。作者探讨了对于临床局限性疾病患者，是否有证据支持这一观点。
作者检索了MEDLINE上的已发表文献。
作者在文献中未发现令人信服的证据表明怀孕会对临床局限性皮肤黑色素瘤患者的生存产生负面影响。最近两项基于人群的研究报告称，将怀孕的黑色素瘤患者与未怀孕的性别匹配对照进行比较时，怀孕对生存没有负面影响。最近一项基于人群的研究发现特定病因死亡风险略有增加，不过这种影响很小（风险比，1.52；P = 0.47），且怀孕患者更有可能出现轴向原发部位，而这与较差的预后相关。
没有令人信服的证据表明怀孕会对患有临床局限性疾病的黑色素瘤患者的预后产生不利影响。已发表的医学文献并不支持继续建议这些患者推迟生育。
