Cutaneous melanoma primary site is linked to nevus density.

Alejandro Martin-Gorgojo,Marta Llinares,Eduardo Nagore,Víctor Traves,Rajiv Kumar,Celia Requena,Zaida Garcia-Casado,Amaya Virós

doi:10.18632/oncotarget.22016

Abstract

There are at least two pathways driving cutaneous melanoma; one is linked to an inherent melanoma susceptibility to nevi development and the second to environmental cumulative ultraviolet light exposure. In this study, we examined the relation between nevus density, accrued sun damage and the site of primary melanoma excision.In a series of 888 consecutive cutaneous melanoma patients, melanomas appearing in skin areas with a high relative nevus density were most prominent in men, with an elevated nevus count, at sites without solar elastosis, but with an epidemiological history of previous sunburn.The present study associates melanoma development to sites with high nevus density. Our study supports more careful surveillance of body areas with increased nevus density in patients with high total body number of nevi, especially when they report a history of sunburns at these sites.

Highlights

By studying risk behavior and epidemiological characteristics of melanoma patients, Whiteman et al proposed a dual pathway to melanoma acquisition [1, 2]
When patients were grouped according to the nevus density at the melanoma region, a high nevus density was significantly associated with young age at presentation, a high total body nevus count and density, and presence of one or more non-synonymous MC1R variants
When comparing patients classified by the sitespecific relative nevus density, melanomas located on an area with a higher nevus density than the total body density occurred more frequently in patients who were men (53.3%), were 45 years of age or younger (39.1%) and had a high total body nevus density (49.1% had >10.6 nevi/m2)

Summary

Introduction

By studying risk behavior and epidemiological characteristics of melanoma patients, Whiteman et al proposed a dual pathway to melanoma acquisition [1, 2]. Patients developing melanoma through this second pathway have typically fair skin and signs of chronic sun damage, other UVR-related non-melanoma skin cancers and the expression of p53 protein in the primary tumor [4]. The nevus-prone pathway underpins melanoma patients with multiple nevi, it is unclear whether the primary melanoma in this context is more likely to arise at sites where the number of nevi is highest [5,6,7,8,9]. Nevi are not distributed homogeneously on the body and their location can be influenced by genetic and environmental (UVR) factors, so we investigated whether the site of primary melanoma is related to the relative density of nevi on the cutaneous area where it arises. Www.impactjournals.com/oncotarget we present the clinical and epidemiological features of primary melanoma in relation to the nevus density at the site they develop, and investigate the care implications

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Conclusion