Abstract
Background In patients with primary cutaneous melanoma (PM), the reported incidence of a second PM ranges between 0.6% and 8.6%. In this large international multi-institution study, we sought to compare the pathological features of first and subsequent PMs in patients with multiple PM (MPM). Methods The Genes, Environment and Melanoma study (GEM) includes melanoma patients from United States, Canada, Italy and Australia. Pathological characteristics of the first (PM1) and subsequent (PM2) invasive PM were compared. Results There were 462 patients with MPM. Compared to invasive PM1, PM2 were more commonly located in the head/neck region (24% vs 16%, p = 0.01), more often lentigo maligna subtype (23% vs 13%, p Conclusions In patients with MPM, PM2 show different pathologic features to those of PM1, which probably reflect closer clinical scrutiny and earlier diagnosis. The increased association of PM2 with DN and indices of solar exposure suggests that they are risk markers for the development of MPM.
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