This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hansson, J. Articles by Rosdahl, I. Search for Related Content PubMed PubMed Citation Articles by Hansson, J. Articles by Rosdahl, I. Social Bookmarking                            What's this?

Monitoring of Kindreds With Hereditary Predisposition for Cutaneous Melanoma and Dysplastic Nevus Syndrome: Results of a Swedish Preventive Program

Johan Hansson, Mia Bergenmar, Per-Åke Hofer, Göran Lundell, Eva Månsson-Brahme, Ulrik Ringborg, Ingrid Synnerstad, Annika Ternesten Bratel, Ann-Marie Wennberg, Inger Rosdahl

From the Department of Oncology-Pathology, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm; Department of Dermatology and Pathology, University Hospital, Umeå; Department of Dermatology, Linköping University Hospital, Linköping; Consultant Group Histopathology, Capio Diagnostics; and the Department of Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden

Address reprint requests to Johan Hansson, MD, PhD, Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital Solna, S-171 76 Stockholm, Sweden; e-mail:johan.hansson{at}ki.se

Purpose To evaluate a program initiated in 1987 by the Swedish Melanoma Study Group aiming to provide preventive surveillance to kindreds with hereditary cutaneous melanoma and dysplastic nevus syndrome.

Patients and Methods Overall, 2,080 individuals belonging to 280 melanoma families were followed for 14 years between 1987 and 2001 at 12 participating centers. Data were registered in a central database.

Results Among 1,912 skin lesions excised during follow-up, 41 melanomas were removed in 32 individuals. Of these, 15 (37%) were in situ melanomas and 26 (63%) invasive melanomas. The median tumor thickness of invasive melanomas was 0.5 mm. Ulceration was absent in 24 of 26 invasive melanomas (92%) and 12 (46%) lacked vertical growth phase. Compared with melanomas in the general Swedish population, the melanomas identified in these kindreds during follow-up had better prognostic characteristics. All melanomas except one were diagnosed in families with two or more first-degree relatives with melanoma. Diagnosis of melanoma occurred in three of eight kindreds with germline CDKN2A mutations, supporting that families with such mutations are at increased risk for melanoma development. Of the 32 individuals who developed melanoma during follow-up, 21 (66%) had had at least one previously diagnosed melanoma.

Conclusion This study shows that a coordinated program aimed at detecting and offering skin surveillance in kindreds with hereditary cutaneous melanoma results in a low incidence of melanomas during the follow-up period and that the tumors that do arise have favorable prognostic characteristics.

Supported by grants from the Swedish Cancer Society and the Research Funds of Radiumhemmet, Stockholm, Sweden.

Presented in part at the 3rd EUROSKIN Conference, Stockholm, Sweden, September 16-19, 2003.

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

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?