High nevus counts confer a favorable prognosis in melanoma patients |
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| Authors: | Simone Ribero John R. Davies Celia Requena Cristina Carrera Daniel Glass Ramon Rull Sergi Vidal‐Sicart Antonio Vilalta Lucia Alos Virtudes Soriano Pietro Quaglino Victor Traves Julia A. Newton‐Bishop Eduardo Nagore Josep Malvehy Susana Puig Veronique Bataille |
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| Affiliation: | 1. Department of Twin Research & Genetic Epidemiology, King's College London, London, United Kingdom;2. Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy;3. Department of Dermatology, London North West Healthcare NHS Trust Northwick Park Hospital, London, United Kingdom;4. Imperial College London, London, United Kingdom;5. Section of Epidemiology and Biostatistics, LICAP, University of Leeds, Leeds, United Kingdom;6. Department of Dermatology, Instituto Valenciano De Oncolog?a, Valencia, Spain;7. Department of Dermatology, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain;8. Department of Surgery, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain;9. Department of Nuclear Medicine Service, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain;10. Department of Pathology Service, Melanoma Unit, Hospital Clinic & IDIBAPS, University of Barcelona, Barcelona, Spain;11. Department of Oncology, Instituto Valenciano De Oncolog?a, Valencia, Spain;12. Department of Pathology, Instituto Valenciano De Oncolog?a, Valencia, Spain;13. Instituto de Salud Carlos III, CIBER on Rare Diseases, Barcelona, Spain;14. Department of Dermatology, West Herts NHS Trust, Hertfordshire, United Kingdom |
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| Abstract: | A high number of nevi is the most significant phenotypic risk factor for melanoma and is in part genetically determined. The number of nevi decreases from middle age onward but this senescence can be delayed in patients with melanoma. We investigated the effects of nevus number count on sentinel node status and melanoma survival in a large cohort of melanoma cases. Out of 2,184 melanoma cases, 684 (31.3%) had a high nevus count (>50). High nevus counts were associated with favorable prognostic factors such as lower Breslow thickness, less ulceration and lower mitotic rate, despite adjustment for age. Nevus count was not predictive of sentinel node status. The crude 5‐ and 10‐year melanoma‐specific survival rate was higher in melanomas cases with a high nevus count compared to those with a low nevus count (91.2 vs. 86.4% and 87.2 vs. 79%, respectively). The difference in survival remained significant after adjusting for all known melanoma prognostic factors (hazard ratio [HR] = 0.43, confidence interval [CI] = 0.21–0.89). The favorable prognostic value of a high nevus count was also seen within the positive sentinel node subgroup of patients (HR = 0.22, CI = 0.08–0.60). High nevus count is associated with a better melanoma survival, even in the subgroup of patients with positive sentinel lymph node. This suggests a different biological behavior of melanoma tumors in patients with an excess of nevi. |
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| Keywords: | nevus count survival sentinel lymph node melanoma |
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