Outcome of patients with de novo versus nevus-associated melanoma

J Am Acad Dermatol. 2015 Jan;72(1):54-8. doi: 10.1016/j.jaad.2014.09.028. Epub 2014 Oct 18.


Background: Prior reports indicate a wide range of melanomas in histopathologic contiguity with a nevus, and an associated nevus has unclear prognostic implications in melanoma.

Objective: We sought to investigate the relationship among nevus-associated melanomas, sentinel lymph node status, and overall survival.

Methods: We conducted a retrospective analysis of 850 patients with cutaneous melanoma and sentinel lymph node removed at Massachusetts General Hospital from 1998 through 2008 and meta-analysis of the literature.

Results: Nevus-associated melanomas represented 28% (235/850) of cases and were significantly correlated with younger age (P = .03), truncal site (P = .0005), superficial spreading type (P < .0001), and absent ulceration (P = .005). There was no association with sentinel lymph node status (P = .94) and no survival difference between nevus-associated versus de novo melanoma (P = .41). Meta-analysis of over 4000 cases revealed a similar percentage of associated nevi (32%).

Limitations: This was a retrospective study.

Conclusions: Approximately 30% of melanomas are associated with a nevus. The presence of a nevus associated with a melanoma has no prognostic implication in sentinel lymph node status or overall survival.

Keywords: dysplastic nevus; melanoma; nevus; overall survival; precursor; sentinel lymph node biopsy.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Melanoma / mortality
  • Melanoma / pathology*
  • Middle Aged
  • Neoplasms, Multiple Primary / mortality
  • Neoplasms, Multiple Primary / pathology*
  • Nevus / mortality
  • Nevus / pathology*
  • Prognosis
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology*
  • Survival Rate
  • Young Adult