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Annals of Oncology Advance Access published online on July 21, 2009
Annals of Oncology, doi:10.1093/annonc/mdp325
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Vitiligo is an independent favourable prognostic factor in stage III and IV metastatic melanoma patients: results from a single-institution hospital-based observational cohort study

P. Quaglino1,*, F. Marenco1, S. Osella-Abate1, N. Cappello2, M. Ortoncelli1, B. Salomone1, M. T. Fierro1, P. Savoia1 and M. G. Bernengo1

1 Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division
2 Department of Genetics, Biology and Biochemistry, University of Turin, Turin, Italy

* Correspondence to: Dr P. Quaglino, Department of Biomedical Sciences and Human Oncology, Section of Dermatology, University of Turin, via Cherasco 23, 10126 Turin, Italy. Tel: +39-11-633-58-16; Fax: +39-11-67-40-34; E-mail: pietro.quaglino{at}unito.it

Background: The clinical features and the prognostic relevance of vitiligo lesions in melanoma patients are still controversial. This prospective observational study was designed to characterise the clinical features of melanoma-associated vitiligo, to analyse the association with other autoimmune manifestations and to ascertain whether the development of vitiligo lesions carries a prognostic relevance on the clinical course of melanoma.

Materials and methods: A total of 2954 consecutive patients have been included; multivariate analyses of distant metastasis-free survival (DMFS) and overall survival (OS) were carried out to ascertain the independent prognostic role of vitiligo as a time-dependent covariate.

Results: Vitiligo was demonstrated in 83 of 2954 melanoma patients (2.8%). A significantly higher percentage of autoimmune diseases was demonstrated in vitiligo patients (7 of 83) with respect to patients without vitiligo (80 of 2871) (P = 0.004). Multivariate analyses selected the time-dependent covariate vitiligo as the favourable independent prognostic variable associated to a longer DMFS in stage III and a higher OS in both stage III and stage IV.

Conclusion: Melanoma-associated vitiligo should be considered as a distinct clinical entity, separate from vitiligo vulgaris, and identifies a subgroup of patients characterised by a high prevalence of immune-mediated diseases and by a favourable prognosis.

autoimmune diseases, melanoma, multivariate analyses, prognosis, vitiligo

Received for publication March 18, 2009. Revision received May 13, 2009. Accepted for publication May 13, 2009.


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