High nevus counts confer a favorable prognosis in melanoma patients.
A high number of nevi is the most significant phenotypic risk factor for melanoma and is in part genetically determined. The number of nevi decreases from middle age onward but this senescence can be delayed in patients with melanoma. We investigated the effects of nevus number count on sentinel node status and melanoma survival in a large cohort of melanoma cases. Out of 2,184 melanoma cases, 684 (31.3%) had a high nevus count (>50). High nevus counts were associated with favorable prognostic factors such as lower Breslow thickness, less ulceration and lower mitotic rate, despite adjustment for age. Nevus count was not predictive of sentinel node status. The crude 5- and 10-year melanoma-specific survival rate was higher in melanomas cases with a high nevus count compared to those with a low nevus count (91.2 vs. 86.4% and 87.2 vs. 79%, respectively). The difference in survival remained significant after adjusting for all known melanoma prognostic factors (hazard ratio [HR] = 0.43, confidence interval [CI] = 0.21-0.89). The favorable prognostic value of a high nevus count was also seen within the positive sentinel node subgroup of patients (HR = 0.22, CI = 0.08-0.60). High nevus count is associated with a better melanoma survival, even in the subgroup of patients with positive sentinel lymph node. This suggests a different biological behavior of melanoma tumors in patients with an excess of nevi.
['Ribero|Simone|S|', 'Davies|John R|JR|', 'Requena|Celia|C|', 'Carrera|Cristina|C|', 'Glass|Daniel|D|', 'Rull|Ramon|R|', 'Vidal-Sicart|Sergi|S|', 'Vilalta|Antonio|A|', 'Alos|Lucia|L|', 'Soriano|Virtudes|V|', 'Quaglino|Pietro|P|', 'Traves|Victor|V|', 'Newton-Bishop|Julia A|JA|', 'Nagore|Eduardo|E|', 'Malvehy|Josep|J|', 'Puig|Susana|S|', 'Bataille|Veronique|V|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D005260:Female D006801:Humans D008297:Male D008545:Melanoma D008875:Middle Aged D009506:Nevus D011379:Prognosis D012189:Retrospective Studies D021701:Sentinel Lymph Node Biopsy D012878:Skin Neoplasms D013030:Spain D015996:Survival Rate D006113:United Kingdom D055815:Young Adult
nevus count melanoma survival sentinel lymph node