title: Melanoma in Mexico: Clinicopathologic Features in a Population with Predominance of Acral Lentiginous Subtype.
abstract: The aim of this study was to analyze the clinicopathologic features of melanoma in México as the demographics of melanoma are not well known in Mexican and Latin American people.
  
  
  
  A total of 1219 patients with cutaneous melanoma were analyzed through a retrospective database collected from a cancer referral institute, and the results were compared with developed countries.
  
  
  
  Median age was 57 years, and 713 (58.5 %) were females. The most common melanoma subtype was acral lentiginous melanoma (ALM), which was observed in 538 (44.1 %) patients. Median Breslow thickness was 5.2 mm. Among 837 patients with complete data, the 5-year disease-specific survival (DSS) was 52.3 %. Factors associated with worse DSS on univariate analysis were Breslow thickness (p < 0.001), recurrence (p < 0.001), ulceration (p < 0.001), positive margin (p < 0.001), ALM (p = 0.001), and male sex (p = 0.001). Multivariate analysis demonstrated Breslow thickness [hazard ratio (HR) 1.45, 95 % confidence interval (CI) 1.27-1.65; p < 0.001], positive margin (HR 1.25, 95 % CI 1.03-1.57; p = 0.018), recurrence (HR 9.56, 95 % CI 6.89-9.87; p = 0.002), ALM (HR 8.07, 95 % CI 6.77-8.95; p = 0.004), and male sex (HR 1.33, 95 % CI 1.06-1.68; p = 0.013) as independent risk factors for DSS.
  
  
  
  Our patients had worse prognosis compared with data from the US Surveillance, Epidemiology, and End Results database. We found male sex and ALM as independent risk factors for worse survival, in addition to known risk factors.
authors.affiliation: Department of Anatomic Pathology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico. saul.lino.sil@gmail.com.
authors.forename: Leonardo S
authors.initials: LS
authors.lastname: Lino-Silva
authors.affiliation: Medicine Faculty, Mexico's National Autonomous University (UNAM), Mexico City, Mexico.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Domínguez-Rodríguez
authors.affiliation: Department of Surgical Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
authors.forename: José M
authors.initials: JM
authors.lastname: Aguilar-Romero
authors.affiliation: Department of Surgical Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
authors.forename: Héctor
authors.initials: H
authors.lastname: Martínez-Said
authors.affiliation: Department of Surgical Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
authors.forename: Rosa A
authors.initials: RA
authors.lastname: Salcedo-Hernández
authors.affiliation: Medicine Faculty, Autonomous University State of Mexico, Toluca, Mexico.
authors.forename: Leticia
authors.initials: L
authors.lastname: García-Pérez
authors.affiliation: Department of Surgical Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Herrera-Gómez
authors.affiliation: Department of Surgical Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
authors.forename: Mario
authors.initials: M
authors.lastname: Cuellar-Hubbe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities; D005260:Female; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D015994:Incidence; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate; D047368:Tumor Burden; D055815:Young Adult