title: Clinical Patterns of Melanoma in Asians: 11-Year Experience in a Tertiary Referral Center.
abstract: BACKGROUND
  Malignant melanoma is a relatively common malignancy in the West, but has a significantly lower incidence in Asians. Stark contrast in clinicopathological characteristics and prognosis has been observed between the 2 populations, yet data are limited. Here, we evaluate 106 Asian patients from a tertiary referral center in Hong Kong during an 11-year period. The purpose of this study was to collectively review all types of melanomas to analyze the clinicopathological characteristics of this poorly understood condition in an Asian population.
  
  
  METHODS
  A total of 106 patients diagnosed with malignant melanoma from 2002 to 2012 were retrospectively reviewed. Demographics, clinical presentations, pathological subtypes, treatments, and survival outcomes were evaluated.
  
  
  RESULTS
  Cutaneous melanomas dominated with 46 (43.4%) cases, followed by mucosal (39.6%), ocular (9.4%), and melanomas of unknown primary (7.5%); 43.3% patients presented in stage I, 36.7% in stage II, 18.9% in stage III, and 1.1% in stage IV. Acral lentiginous melanoma was the commonest subtype of cutaneous melanomas (60.9%). When types of melanomas were reviewed collectively, the median overall survival, disease-specific survival, and recurrence-free survival were 37, 45, and 48 months, respectively. Cutaneous melanoma had the best median overall survival of 59 months, followed by ocular melanoma (58 months), mucosal melanoma (18 months), and melanoma of unknown primary (2 months). Similar patterns were observed for disease-specific survival and recurrence-free survival.
  
  
  CONCLUSIONS
  Melanoma among Asians remains poorly understood. There is a clear distinction in the clinical patterns between Asians and whites and the difference is not solely accounted for by the lower incidence of cutaneous melanoma. Certain subtypes, such as mucosal melanoma and is acral lentiginous melanoma, seemed to have disproportionately high incidences. Further studies are warranted to elucidate these observations. The poor survival outcomes reflected the need for better awareness and understanding of the condition by both the general public and the physicians.
authors.affiliation: From the *University of Hong Kong; †Division of Plastic and Reconstructive Surgery, Department of Surgery, and ‡Department of Pathology, Queen Mary Hospital, Hong Kong.
authors.forename: Karen Kar-Wun
authors.initials: KK
authors.lastname: Chan
authors.forename: Richie Chiu-Lung
authors.initials: RC
authors.lastname: Chan
authors.forename: Ronnie Siu-Lun
authors.initials: RS
authors.lastname: Ho
authors.forename: Jimmy Yu-Wai
authors.initials: JY
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000473:pathology; D044466:Asian People; D002648:Child; D005134:Eye Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000473:pathology; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000208:ethnology / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D062606:Tertiary Care Centers; D014565:Urogenital Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000473:pathology; D055815:Young Adult