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Population-Based Analysis of Prognostic Factors and Survival in Familial Melanoma

From the Departments of Dermatology, Oncological Sciences, Medical Informatics and Internal Medicine, Melanoma Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT

Address reprint requests to Sancy A. Leachman, MD, PhD, Huntsman Cancer Institute, 2000 Circle of Hope, University of Utah Health Sciences Center, Salt Lake City, UT 84112-5550; e-mail: sancy.leachman{at}hci.utah.edu

PURPOSE: Familial melanoma patients are reported to present with thinner melanomas, to be younger at the time of diagnosis, and to have a greater likelihood of developing multiple primary tumors. We sought to determine whether melanomas that occur in a familial setting demonstrate different prognostic and survival statistics relative to sporadic melanoma.

PATIENTS AND METHODS: This population-based study used the Utah Cancer Registry and Utah Population Database to objectively evaluate prognostic and survival statistics of the familial melanoma population. From 1973 to 1999, there were 7,785 cases of invasive melanoma identified through the Utah Cancer Registry. These were linked to the Utah Population Database, resulting in 2,659 subjects with family-history information from which a familiality score could be calculated. Cases scored in the top ninth percentile were assigned as high familial risk, and the remaining 91% were considered low familial risk.

RESULTS: Multivariate logistic-regression analysis found no association between sex, Breslow depth, Clark level, or survival and the familial status. Age at first diagnosis of invasive melanoma was slightly lower in the high-familial-risk group (57 v 60 years; P = .03). High-familial-risk subjects had more melanomas diagnosed at age 30 or younger (12% v 6%; P < .001). A significant difference in the overall number of individuals with two or more primary malignant melanomas was not detected among the groups (P = .2).

CONCLUSION: These data suggest that melanomas occurring in the context of an underlying inherited susceptibility do not have a significantly different biologic behavior.

Supported by the Dermatology Foundation Leaders Society Dermatologist Investigator Research Fellowship and Clinical Career Development Award (S.R.F.), National Institutes of Health Grants No. K23 RR17525-01 (S.R.F.) and CA102422 (L.A.C.-A.), the Doris Duke Charitable Foundation (S.A.L.), Fellowship-to-Faculty Transition Award from the University of Utah, funded in part by the Howard Hughes Medical Institute (S.A.L.), the Huntsman Cancer Foundation (S.A.L.), the Tom C. Mathews Jr Familial Melanoma Research Clinic at Huntsman Cancer Institute, Huntsman General Clinical Research Center Public Health Service Grant No. MO1 RR00064, National Cancer Institute Cancer Center support Grant No. 5P30CA420-14, and the Utah Cancer Registry, funded by Contract No. NCI-CN-67000 from the National Cancer Institute, with additional support from the Utah Department of Health and the University of Utah.

Presented in part at the 2nd International Melanoma Research Congress, Phoenix, AZ, November 13-16, 2004.

The current affiliation for C.W. is the New Mexico Tumor Registry, University of New Mexico, Albuquerque, NM.

The current affiliation for A.T. is the Division of Biostatistics, Department of Epidemiology and Preventive Medicine, University of California at Davis, Davis, CA.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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