Martínez-Campayo Nieves, Paradela de la Morena Sabela, Pértega-Díaz Sonia, Iglesias Pena Luisa, Vihinen Pia, Mattila Kalle, Lens Marko B, Tejera-Vaquerizo Antonio, Fonseca Eduardo
Department of Dermatology, University Hospital of A Coruña, 15006 Corunna, Spain.
Department of Research, University Hospital of A Coruña, 15006 Corunna, Spain.
J Clin Med. 2021 Dec 24;11(1):83. doi: 10.3390/jcm11010083.
Melanoma incidence has increased over the last few decades. How the prognosis of a previously diagnosed melanoma may be affected by a woman's subsequent pregnancy has been debated in the literature since the 1950s, and the outcomes are essential to women who are melanoma survivors in their childbearing years. The main objective of this systematic review is to improve the understanding of whether the course of melanoma in a woman may be altered by a subsequent pregnancy and to help clinicians' diagnosis. Eligible studies for the systematic review were clinical trials, observational cohort studies and case-control studies that compared prognosis outcomes for non-pregnant patients with melanoma, or pregnant before melanoma diagnosis, versus pregnant patients after a diagnosis of melanoma. The search strategy yielded 1101 articles, of which 4 met the inclusion criteria for the systematic review. All the studies were retrospective non-randomised cohorts with patients with melanomas diagnosed before pregnancy. According to our findings, a subsequent pregnancy was not a significant influence on the outcome of a previous melanoma. However, given the small number of identified studies and the heterogeneous data included, it is recommended to approach these patients with caution, and counselling should be given by known prognostic factors. We also reviewed the medical records of 84 patients of childbearing age (35.8 ± 6.3 years, range 21-45 years) who were diagnosed with cutaneous invasive melanoma in our hospital between 2008 and 2018 (N = 724). Of these, 11 (13.1%) had a pregnancy after melanoma diagnosis (age at pregnancy: 35.6 ± 6.3 years). No statistical differences in outcome were detected.
在过去几十年中，黑色素瘤的发病率有所上升。自20世纪50年代以来，先前诊断出的黑色素瘤患者的预后如何受到女性随后怀孕的影响一直是文献中争论的话题，而这些结果对于处于生育年龄的黑色素瘤幸存者女性至关重要。本系统评价的主要目的是增进对女性黑色素瘤病程是否会因随后怀孕而改变的理解，并帮助临床医生进行诊断。纳入该系统评价的合格研究为临床试验、观察性队列研究和病例对照研究，这些研究比较了黑色素瘤非妊娠患者、黑色素瘤诊断前妊娠患者与黑色素瘤诊断后妊娠患者的预后结果。检索策略共获得1101篇文章，其中4篇符合系统评价的纳入标准。所有研究均为回顾性非随机队列研究，研究对象为妊娠前被诊断为黑色素瘤的患者。根据我们的研究结果，随后的怀孕对先前黑色素瘤的预后没有显著影响。然而，鉴于已识别研究数量较少且纳入的数据存在异质性，建议谨慎对待这些患者，并应根据已知的预后因素进行咨询。我们还回顾了2008年至2018年期间在我院诊断为皮肤浸润性黑色素瘤的84名育龄患者（35.8±6.3岁，范围21 - 45岁）的病历（N = 724）。其中，11名（13.1%）在黑色素瘤诊断后怀孕（怀孕时年龄：35.6±6.3岁）。未检测到结果上的统计学差异。
