Acral lentiginous melanoma versus other melanoma: A single-center analysis in Japan.
We summarize herein our 14-year experience of conventional treatment outcomes before the era of molecular-targeted therapy and immunotherapy. Specifically, we conducted a retrospective review of our 252 patients with primary cutaneous melanoma (acral lentiginous melanoma [ALM], n = 121; non-acral lentiginous melanoma [non-ALM], n = 131), and compared the prognostic factors between ALM and non-ALM. Melanoma-specific survival and disease-free survival were estimated using the Kaplan-Meier method. Regarding the results, all patients were Japanese (106 male and 146 female), with a mean age of 60.1 years. Among ALM patients, age was elder and primary tumor size was larger than non-ALM. As for tumor thickness, in situ lesions were more frequently observed in ALM. There was no significant difference in the distribution of tumor thickness between the two groups when excluding the in situ lesions. For treatment of the primary melanoma, 248 patients (98.4%) had undergone curative surgical excision and 120 patients with more than 1 mm or ulcerated melanoma had undergone sentinel lymph node biopsy. Patients with systemic metastasis primarily underwent dacarbazine-based chemotherapy. The Kaplan-Meier survival curves revealed no significant difference in melanoma-specific survival and disease-free survival between those with ALM and non-ALM. The results also showed that both ALM and non-ALM, when they initially metastasize, first affect the regional lymph nodes. Incisional biopsy was not an adverse prognostic factor. These results suggest that ALM does not differ in its biological behavior from non-ALM, so we can consider ALM as being equivalent to non-ALM. The initial treatment for ALM and non-ALM can involve the same strategy.
Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Maiko
http://orcid.org/0000-0001-7617-7038
M
Wada
Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Takamichi
T
Ito
Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.|Research and Clinical Center for Yusho and Dioxin, Kyushu University, Fukuoka, Japan.
Gaku
G
Tsuji
Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.|Division of Skin Surface Sensing, Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Takeshi
T
Nakahara
Department of Health Services Management and Policy, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Akihito
A
Hagihara
Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.|Research and Clinical Center for Yusho and Dioxin, Kyushu University, Fukuoka, Japan.|Division of Skin Surface Sensing, Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Masutaka
M
Furue
Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Hiroshi
H
Uchi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003606:Dacarbazine / Q000627:therapeutic use; D062109:Dermatologic Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents; D003606:Dacarbazine
acral lentiginous melanoma; outcome; prognosis; prognostic factor; sentinel lymph node