title: Unique prognostic factors in acral lentiginous melanoma.
abstract: BACKGROUND
  This study was performed to identify clinicopathologic factors associated with survival in acral lentiginous melanoma.
  
  
  METHODS
  A post hoc analysis of a prospective clinical trial and local database was performed in all patients with acral lentiginous melanomas. Multivariate analyses of factors associated with a tumor-positive sentinel lymph node (SLN) biopsy, disease-free survival (DFS), overall survival (OS), and local and in-transit recurrence-free survival (LITRFS) were performed. Kaplan-Meier survival analyses were performed.
  
  
  RESULTS
  Eighty-five patients were identified. Age younger than 59 years and Breslow thickness (BT) of 2.0 mm or greater were independent risk factors for a positive SLN. SLN status was the only independent risk factor for DFS and LITRFS on multivariate analysis. A BT of 2.0 mm or greater was the only independent risk factor for OS. SLN status distinguished differences in DFS, OS, and LITRFS on Kaplan-Meier analysis.
  
  
  CONCLUSIONS
  SLN status is the dominant factor for recurrence and survival in acral lentiginous melanoma. BT and ulceration are less important in this histologic subtype.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, University of Louisville, 315 East Broadway, Suite 303, Louisville, KY 40202, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Egger
authors.forename: Kelly M
authors.initials: KM
authors.lastname: McMasters
authors.forename: Glenda G
authors.initials: GG
authors.lastname: Callender
authors.forename: Amy R
authors.initials: AR
authors.lastname: Quillo
authors.forename: Robert C G
authors.initials: RC
authors.lastname: Martin
authors.forename: Arnold J
authors.initials: AJ
authors.lastname: Stromberg
authors.forename: Charles R
authors.initials: CR
authors.lastname: Scoggins
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis; D055815:Young Adult