Acral lentiginous melanoma: incidence and survival patterns in the United States, 1986-2005.
OBJECTIVE
To examine incidence and survival patterns of acral lentiginous melanoma (ALM) in the United States.


METHODS
Population-based registry study. We used the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute to evaluate data from 17 population-based cancer registries from 1986 to 2005.


METHODS
A total 1413 subjects with histologically confirmed cases of ALM. Main Outcome Measure Incidence and survival patterns of patients with ALM.


RESULTS
The age-adjusted incidence rate of ALM overall was 1.8 per million person-years. The proportion of ALM among all melanoma subtypes was greatest in blacks (36%). Acral lentiginous melanoma had 5- and 10-year melanoma-specific survival rates of 80.3% and 67.5%, respectively, which were less than those for all cutaneous malignant melanomas overall (91.3% and 87.5%, respectively; P < .001). The ALM 5- and 10-year melanoma-specific survival rates were highest in non-Hispanic whites (82.6% and 69.4%), intermediate in blacks (77.2% and 71.5%), and lowest in Hispanic whites (72.8% and 57.3%) and Asian/Pacific Islanders (70.2% and 54.1%). Acral lentiginous melanoma thickness and stage correlated with survival according to sex and in the different racial groups.


CONCLUSIONS
Population-based data showed that ALM is a rare melanoma subtype, although its proportion among all melanomas is higher in people of color. It is associated with a worse prognosis than cutaneous malignant melanoma overall. Hispanic whites and Asian/Pacific Islanders have worse survival rates than other groups, and factors such as increased tumor thickness and more advanced stage at presentation are the most likely explanations.
Bradford
Porcia T
PT
Genetic Epidemiology Branch, DCEG, NCI, NIH, 6120 Executive Blvd, Room 7005, Rockville, MD 20852-7236, USA. bradfordp@mail.nih.gov
Goldstein
Alisa M
AM
McMaster
Mary L
ML
Tucker
Margaret A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D005121:Extremities; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D014481:United States / Q000453:epidemiology; D055815:Young Adult; D001741:Black or African American