The Impact of Pregnancy on Long-Term Treatment Outcomes in Reproductive-Age Patients with Melanoma

Introduction . Melanoma remains one of the most aggressive malignant skin tumors, and its association with pregnancy or pregnancy planning after treatment presents a multidisciplinary challenge. Historically, physiological hormonal changes and immunosuppression during pregnancy were thought to stimulate tumor growth, but data analysis adjusted for the leading prognostic factor — Breslow tumor thickness — did not confirm an independent negative impact of pregnancy-related melanoma on overall and relapse-free survival. Purpose of the work is to assess the survival rates of patients in the Sverdlovsk region who became pregnant after treatment for melanoma. Material and methods. A retrospective analysis was conducted using medical records from the “Medoffice” information system, as well as the regional information systems ONKOR and the “Pregnant Women Monitoring Program”. The study included patients who conceived following treatment for cutaneous melanoma; a comparison group was also established, consisting of patients with a histologically confirmed diagnosis — matched for age and tumor TNM characteristics — who did not become pregnant. In total, 41 pregnant patients and 66 patients in the comparison group met the selection criteria. Results. In the subgroup of pregnant patients, 1-, 3-, and 5‑year OS were 100 %, in the comparison group, 1‑year OS was 100 %, 3‑year OS was 97.90 %, and 5‑year OS was 95.35 %. When analyzing the RFS indicators in subgroups among pregnant patients, 1-, 3-, and 5‑year RFS were 100 %, in the comparison group, 1‑year OS was 100 %, 3‑year OS was 93.90 %, and 5‑year OS was 87.20 %. Median OS and RFS were not achieved in any subgroup. Conclusions . Both OS and RFS rates were higher among pregnant patients; the difference was statistically significant for RFS. No association was established between pregnancy and an increased risk of death or recurrence.