Menzies Stephanie, Barry Rupert, Ormond Patrick
Department of Dermatology, St James' Hospital, Dublin, Republic of Ireland.
Melanoma Res. 2017 Dec;27(6):638-640. doi: 10.1097/CMR.0000000000000395.
Prognosis has been shown to be worse for patients with multiple primary melanomas than those with a single melanoma. One recent retrospective study showed that older, white men were at higher risk of multiple primary melanomas. In our institution 2057 melanomas were diagnosed between January 1994 and March 2016. We identified 99 (4.8%) patients who had multiple primary melanomas. The average number of melanomas was 2.5 (range: 2-10). The site for first and second melanomas was similar in 30%. We found that subsequent melanomas were more likely to be in situ and thinner in terms of Breslow thickness and Clarks level. The commonest subtypes were superficial spreading and lentigo maligna. The commonest sites involved were the lower limbs. We found no significant difference in age between our total melanoma group and the multiple primary melanoma group (64 and 66 years, respectively). The average time of diagnosis between the first and second melanomas was 33.7 months. Additionally, 70% of second melanomas were diagnosed within 2 years of first diagnosis, highlighting the importance of ongoing skin surveillance in patients with a recent diagnosis of melanoma.
多项原发性黑色素瘤患者的预后已被证明比单一黑色素瘤患者更差。最近一项回顾性研究表明，年龄较大的白人男性患多项原发性黑色素瘤的风险更高。在我们机构，1994年1月至2016年3月期间共诊断出2057例黑色素瘤。我们确定了99例（4.8%）患有多项原发性黑色素瘤的患者。黑色素瘤的平均数量为2.5个（范围：2 - 10个）。30%的患者首次和第二次黑色素瘤的发病部位相似。我们发现，后续的黑色素瘤更可能为原位癌，且在 Breslow 厚度和 Clark 分级方面更薄。最常见的亚型是浅表扩散型和恶性雀斑样痣型。最常累及的部位是下肢。我们发现，总的黑色素瘤组与多项原发性黑色素瘤组之间在年龄上无显著差异（分别为64岁和66岁）。首次和第二次黑色素瘤诊断之间的平均时间为33.7个月。此外，70%的第二次黑色素瘤在首次诊断后的2年内被诊断出来，这突出了对近期诊断为黑色素瘤的患者持续进行皮肤监测的重要性。
