Survival and tumor characteristics of patients presenting with single primary versus second primary melanoma lesions

Abstract

Patients with single primary melanomas have an increased risk of developing subsequent melanomas. Secondary tumors diagnosed within and after three months are termed "synchronous" and "asynchronous," respectively. Compare the tumor distributions and survival characteristics of patients with second primary melanoma subtypes to patients with single primary melanomas. Retrospective cohort study. Data were collected from an institutional database from 14,029 patients with a diagnosis of a primary melanoma seen between 1970 and 2004. The synchronous and asynchronous cohorts demonstrated significantly improved survival probabilities compared to the single primary cohort (p=.04 and .002, respectively). Single primaries (2.2mm, SD=2.3) were significantly thicker than the first identified synchronous (2.0mm, SD=1.7) and the first identified asynchronous lesions (1.7mm, SD= 1.3). Synchronous lesions were more likely to be anatomically concordant compared to asynchronous lesions (55.7% vs 38.2%, p<.001). Our limitations include the single center study design as well as incomplete records for second primary melanoma Breslow depth and histopathology. Patients with second primary melanomas demonstrated a significant survival advantage and thinner lesions compared to single primary melanomas. Our reported tumor distributions support the role of FBSE's, with attention to the region of initial diagnosis.