Cigarette Smoking and Malignant Melanoma: Prognostic Implications

In a prospective study of 178 patients with malignant melanoma, a subset of 33 patients (18.5%) was identified to be at significantly higher risk for developing metastatic disease based on history of cigarette smoking. Patients in this high‐risk group (current smokers with a >15 pack‐years of smoking history) had two‐year disease‐free survival rates of 74.2%, versus 92.3% for the remaining patients (p =0.008). A possible explanation of this phenomenon is that chronic smoking diminishes host defense mechanisms and results in an adverse effect on the biologic behavior of established malignant melanomas. 1981 American Society for Dermatologic Surgery, Inc.