Prognosis of naevoid melanomas

Martin G Cook; Megan Grant; Yvonne Sylvestre; Victoria Akhras; Kiarash Khosrotehrani; Maria Celia B Hughes; Maryrose Malt; B Mark Smithers; Daniela Massi; Vincenzo De Giorgi; Richard Marais; Adele C Green

doi:10.1016/j.prp.2023.154881

Prognosis of naevoid melanomas

Pathol Res Pract. 2023 Nov:251:154881. doi: 10.1016/j.prp.2023.154881. Epub 2023 Oct 9.

Authors

Affiliations

¹ Molecular Oncology Group, Cancer Research UK Manchester Institute, University of Manchester, Macclesfield SK10 4TG, UK; Royal Surrey NHS Foundation Trust, Guildford, UK; Division of Clinical Medicine, University of Surrey, Guildford, Surrey, UK; Members of EORTC Melanoma Pathology Working Group, Belgium.
² Molecular Oncology Group, Cancer Research UK Manchester Institute, University of Manchester, Macclesfield SK10 4TG, UK.
³ Centre for Biostatistics, Division of Population Health, Health Services Research & Primary Care School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, UK.
⁴ Department of Dermatology, St George's Hospital, London, UK.
⁵ Department of Dermatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; The University of Queensland, Frazer Institute, Brisbane, Queensland, Australia.
⁶ QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
⁷ Queensland Melanoma Project, Princess Alexandra Hospital, The University of Queensland, Australia.
⁸ Members of EORTC Melanoma Pathology Working Group, Belgium; Section of Pathological Anatomy, Department of Health Sciences, University of Florence, Florence, Italy.
⁹ Section of Dermatology, Department of Health Sciences, University of Florence, Italy.
¹⁰ Molecular Oncology Group, Cancer Research UK Manchester Institute, University of Manchester, Macclesfield SK10 4TG, UK; QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. Electronic address: adele.green@qimrberghofer.edu.au.

PMID: 37832354
DOI: 10.1016/j.prp.2023.154881

Abstract

Introduction: There appear to be several variants of naevoid melanoma suspected as having different outcomes, but follow-up studies have been few. We aimed to assess the prognosis of naevoid melanomas in a multi-centre study.

Material and methods: From histopathology records we ascertained patients in the UK, Australia and Italy diagnosed with maturing naevoid melanoma (n = 65; 14; 7 respectively) and nodular/papillomatous naevoid melanoma (12; 6; 0), and patients with superficial spreading melanoma (SSM) from UK (73) and Australia (26). Melanoma deaths in UK patients were obtained from NHS Digital; in Australia, via the National Death Index and cancer registry; and in Italy, through clinical records. For maturing naevoid vs. SSM, we used Cox-proportional hazard regression models to compare survival adjusted for age, sex, tumour thickness, and ulceration, and additionally Fine-Gray regression analysis, to calculate sub-hazard ratios (SHR) in the UK cohort, accounting for competing causes of death.

Results: Among UK patients, there was a non-significantly lower risk of melanoma death in maturing naevoid vs SSM, including after accounting for competing causes of death (SHR 0.40, 95% confidence interval (CI) 0.12-1.31), while among nodular/papillomatous naevoid melanoma patients, there were no melanoma deaths on follow-up. Two melanoma deaths occurred in Australian SSM patients, and none in maturing or nodular/papillomatous naevoid melanoma patients, after 5 years' minimum follow-up. None of the 7 Italian patients with maturing naevoid melanoma died of melanoma after nearly 12 years' average follow-up.

Conclusions: There was no significant difference in risk of death from melanomas with naevoid features, and SSM. Nodular/ papillomatous naevoid melanoma patients did not carry higher risk of death than SSM patients though the very few cases of the papillomatous naevoid variant limited our assessment.

Keywords: Maturing naevoid melanoma; Naevoid melanoma; Nodular melanoma; Papillomatous melanoma; Superficial spreading melanoma.

Publication types

Multicenter Study

MeSH terms

Australia / epidemiology
Humans
Melanoma* / pathology
Melanoma, Cutaneous Malignant
Papilloma*
Prognosis
Skin Neoplasms* / pathology