title: The Prognosis of Nail Apparatus Melanoma: 20 Years of Experience from a Single Institute.
abstract: OBJECTIVE
  Nail apparatus melanoma (NAM) is an uncommon tumor, especially in Caucasians. The prognosis of patients affected by NAM was analyzed and correlated with the histopathological criteria and the surgical management of the tumors.
  
  
  METHODS
  We collected data regarding NAM referred to the Skin Cancer Unit of the Dermatology Department of the University of Bologna, from 1992 to January 2012.
  
  
  RESULTS
  Out of 1,327 melanoma cases diagnosed between 1992 and 2012, 42 patients were affected by NAM (2.93%). All the patients were Caucasian. Two deceased patients with insufficient medical records and 1 woman with a personal history of breast cancer were excluded. Thirty-nine cases entered this study: 24 were women (67%) and 15 men (33%). The mean age at diagnosis of NAM was 57.3 years (range 29-88 years). Statistical analyses showed that prognosis was significantly correlated with the Breslow thickness (≥/<2 mm; p = 0.02), regression (p < 0.0001) and ulceration (p = 0.04). Regarding surgical management, Kaplan-Meier's test pointed out that performing functional surgery compared to disarticulation did not correlate with a better prognosis of patients (p = 0.08).
  
  
  CONCLUSIONS
  In our experience, the surgical management (disarticulation with respect to functional surgical excision) did not influence the prognosis of NAM patients. The latter was affected by the histopathological characteristics (Breslow thickness, regression and mitoses) and location (fingers vs. foot).
authors.affiliation: Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
authors.forename: Emi
authors.initials: E
authors.lastname: Dika
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
authors.forename: Pier Alessandro
authors.initials: PA
authors.lastname: Fanti
authors.forename: Marco Adriano
authors.initials: MA
authors.lastname: Chessa
authors.forename: Camilla
authors.initials: C
authors.lastname: Reggiani
authors.forename: Alessia
authors.initials: A
authors.lastname: Barisani
authors.forename: Bianca Maria
authors.initials: BM
authors.lastname: Piraccini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004188:Disarticulation; D005260:Female; D006214:Hallux; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D008940:Mitotic Index; D009260:Nail Diseases / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D012883:Skin Ulcer / Q000209:etiology; D013933:Thumb; D047368:Tumor Burden