Volar location and degree of pigmentation are associated with poor survival and first metastasis pattern in acral melanoma

The risk factors affecting acral melanoma metastasis and prognosis remain unclear. The study included 168 patients with invasive acral melanoma who were followed for ≥3 years. We evaluated patient demographics, stages, clinicopathological features, anatomic site of melanoma including nail versus vol...

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Bibliographic Details
Published in:Pigment cell and melanoma research 2021-11, Vol.34 (6), p.1094-1104
Main Authors: Ryu, Geon Wook, Choi, Yoo Duk, Jin, Suna, Chung, Ik‐Joo, Shin, Min‐Ho, Yun, Sook Jung
Format: Article
Language:English
Subjects:
acral melanoma
Adult
Aged
Aged, 80 and over
Biopsy
Confidence intervals
Demographics
Demography
Disease-Free Survival
Female
first metastasis
Humans
location
Lymph nodes
Lymphatic Metastasis
Lymphatic system
Male
Medical prognosis
Melanoma
Melanoma - metabolism
Melanoma - mortality
Melanoma - pathology
Melanoma, Cutaneous Malignant
Metastases
Metastasis
Middle Aged
Pigmentation
Pigmentation Disorders - metabolism
Pigmentation Disorders - mortality
Pigmentation Disorders - pathology
Risk analysis
Risk factors
Sentinel Lymph Node Biopsy
Skin Neoplasms - metabolism
Skin Neoplasms - mortality
Skin Neoplasms - pathology
survival
Survival Rate
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Summary:The risk factors affecting acral melanoma metastasis and prognosis remain unclear. The study included 168 patients with invasive acral melanoma who were followed for ≥3 years. We evaluated patient demographics, stages, clinicopathological features, anatomic site of melanoma including nail versus volar surface, and degree of melanoma pigmentations, sentinel lymph node biopsy results, and the first metastasis sites. Of the 168 patients (mean age 64.5 years; 52.4% male), 43 (25.6%) had invasive melanoma without metastasis, 113 (67.3%) had invasive melanoma with a first lymph node metastasis, and 12 (7.1%) had invasive melanoma with invasive melanoma with a first distant metastasis. Advanced T stage, high mitotic rate, ulceration, and the degree of pigmentation were significant risk factors for metastasis. Amelanotic and mild pigmentation of acral melanoma was associated with first distant metastasis, whereas heavy pigmentation was associated with first lymph node metastasis. Advanced TNM stages, high mitotic rate, volar location (hazard ratio = 2.24, 95% confidence interval 1.18–4.26), and low‐pigmentation (hazard ratio = 2.02, 95% confidence interval 1.17–3.49) were associated with melanoma‐specific mortality.
ISSN:1755-1471
1755-148X
DOI:10.1111/pcmr.12983