Patients with multiple primary melanomas have worse overall survival than those with a single primary melanoma, according to a study published online in JAMA Dermatology.

Mary-Ann El Sharouni, M.D., from the University Medical Center Utrecht in the Netherlands, and colleagues described the epidemiologic features of multiple primary melanoma in a retrospective population-based cohort study. Adults with histologically proven, primary, invasive cutaneous melanoma during Jan. 1, 2000, through Dec. 31, 2014, were followed for a median of 75.1 months. Data were included for 56,929 patients total (54,645 single primary melanomas and 4,967 multiple primary melanomas in 2,284 patients).

The researchers found a decrease in the median Breslow thickness from 0.90 mm for the first melanoma to 0.65 mm for the second melanoma. For the second melanoma, 16.2 percent of patients had a higher T stage, 48.7 percent had the same T stage, and 35.1 percent had a lower T stage. In patients with multiple primary melanomas, 36.8 and 27.3 percent were found during the first year of follow-up and after five years of follow-up, respectively. Patients with multiple primary melanomas had worse overall survival than those with a single primary melanoma (hazard ratio, 1.31).

"The findings suggest that current melanoma follow-up strategies need to be reconsidered for patients with multiple primary melanomas and guidelines should comment on this," the authors write.

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