Among 100 patients diagnosed with melanoma during pregnancy and followed a mean of 6.8 years, when compared with a nonpregnant female population, there was a significantly shorter disease-free interval for the pregnant group. Median disease-free intervals were 5.8 and 11.9 years, respectively. The time to development of lymph node metastases was shorter in the pregnant patients (p = 0.015). Nodal metastases developed in 48% of the pregnant patients and only 26% of the nonpregnant patients, at 10 years. Multivariate analysis demonstrated that pregnancy at diagnosis was significantly associated with the development of metastatic disease (p = 0.008), when controlling for tumor site, thickness, and Clark level. Pregnancy, however, was not a risk factor for patient mortality. The literature continues to be split on the role of pregnancy in melanoma; however, most recent series show no difference in survival. Multiple studies have failed to show significant effects of female hormones on melanoma cells or on the incidence or progression of melanoma.
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