A systematic review was performed to answer the following question: 'Does pregnancy following a diagnosis of melanoma affect prognosis?
Evidence summary and recommendations
There is little information in the literature regarding the effect of subsequent pregnancy on the prognosis of melanoma. A systematic review and meta-analysis in 2015 evaluated the effect of pregnancy following diagnosis and treatment of melanoma. There were only five eligible studies identified for inclusion in the analysis, 2 population cohort studies and 3 retrospective clinical cohort studies, with these studies suggesting that the risk of mortality from melanoma did not increase in a subsequent pregnancy. Older studies have shown that pregnancy does not increase the subsequent risk of having melanoma, with no increased risk of melanoma developing during subsequent pregnancy. Moreover, women with higher parity have a reduced risk of melanoma. There appears to be no effect of subsequent pregnancy on the prognosis of melanoma.
|Pregnancy-associated cutaneous melanoma may have an increased risk of mortality.||III-3||, |
|Pregnancy occurring following treatment of melanoma does not appear to increase the risk of recurrence.||III-3|||
Note on recommendations based on this evidence
No direct recommendations were formulated based on this evidence because it serves to describe prognosis, not to evaluate the effects of interventions to manage prognosis.
Regular skin examination should be performed in pregnant women so that suspicious lesions can be dealt with in a timely fashion.
There are no standard guidelines for patients who wish to become pregnant after the diagnosis and treatment of melanoma. It has been recommended that women avoid pregnancy for two to five years after the diagnosis of high-risk melanoma, whether or not the melanoma occurred during pregnancy, as most recurrences are diagnosed within this period. However, recurrence is not always predictable and factors such as the age of the patient and the features of the melanoma need to be taken into account when pregnancy is contemplated following treatment of melanoma.
Women of childbearing age who are within five years of primary treatment of a high-risk melanoma should be fully informed of their prognosis when considering pregnancy.
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