Second malignancies in melanoma patients in Thuringia

Objective The incidence of melanoma is increasing. Melanoma patients are at risk for the development of second neoplasias. Data for the new German Bun deslander are not available, but would be suitable to define frequency, sit e and type of secondary malignancies and conclusions for follow-up of melan oma patients. Design Retrospective study at the Melanoma Outpatient Clinic of the Departm ent of Dermatology and Allergology at the University of Jena (Germany) for patients seen between Tune 1966 and June 1999. To investigate the impact of second malignancies on survival a case-comparison study of mortality was p erformed. The log-rank test and chi (2) -test were used to investigate stat istical significance. There were 554 patients with malignant melanoma, 237 male and 317 female, with an age at time of diagnosis between 17.0 and 90.1 years (mean 53.7 years). The mean follow-up was 5.6 years. Results Sixty-one patients (11.0%) developed a second tumour. The total num ber of tumours was 83. Forty-five patients developed one, 16 developed grea ter than or equal to 2 second tumours. Basal cell carcinoma (BBC) was the m ost frequent neoplasia (17 patients, 22 tumours; mean age 64.9 years). A se cond melanoma was found in 15 patients, while two developed a third melanom a. The mean tumour thickness was 0.81 mm tin second or third melanomas) com pared with 1.92 mm of primary melanomas. Seven female patients developed br east cancer (eight: cancers; mean age 57.3 years). The other second tumours included skin cancer (eight), gastrointestinal tract tumours (four), genit al cancers (19), brain tumours (two),lung cancer (two) and other tumours (s ix). The difference in survival of patients with second tumours was not sta tistically significant from age-, sex- and melanoma thickness-matched contr ols. Conclusions Second malignancies were seen in 11.0% of melanoma patients. Mo st important are second skin tumours such as second melanomas and BCC, reco mmending follow-up by the dermatologist. In a group of patients with regula r follow-up examinations, no negative impact of second tumours (BCC, melano ma, breast cancer) on overall survival could be detected.