Y Teramoto1,2, U Keim1,3, A Gesierich4, G Schuler5, E Fiedler6, T Tüting7, C Ulrich8, U Wollina9, J C Hassel10, R Gutzmer11, S Goerdt12, C Zouboulis13, U Leiter1, T K Eigentler1, C Garbe1. 1. Division for Dermatooncology, Department of Dermatology, University Hospital Tuebingen, Tuebingen, Germany. 2. Department of Skin Oncology/Dermatology, Comprehensive Cancer Centre, Saitama Medical University International Medical Centre, Saitama, Japan. 3. Central Malignant Melanoma Registry, University Hospital Tuebingen, Tuebingen, Germany. 4. Department of Dermatology, University Hospital Wuerzburg, Wuerzburg, Germany. 5. Department of Dermatology, University Hospital Erlangen, Erlangen, Germany. 6. Skin Cancer Centre, Department of Dermatology, University Hospital Halle, Halle, Germany. 7. Department of Dermatology, University Hospital Magdeburg, Magdeburg, Germany. 8. Skin Cancer Centre, Department of Dermatology, Charité Berlin, Berlin, Germany. 9. Department of Dermatology and Allergology, Hospital Dresden Friedrichsstadt, Dresden, Germany. 10. Department of Dermatology and National Centre for Tumour Diseases, University Hospital Heidelberg, Heidelberg, Germany. 11. Skin Cancer Centre, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany. 12. Department of Dermatology, University Hospital Mannheim, Mannheim, Germany. 13. Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Centre, Medical University of Brandenburg, Dessau, Germany.
Abstract
BACKGROUND: Acral lentiginous melanoma (ALM) is one of the four major subtypes in cutaneous melanoma (CM). Although ALM has a poorer prognosis than other CM subtypes, the prognostic factors associated with ALM have only been verified in small-sized cohorts because of the low incidence of ALM worldwide. OBJECTIVES: To investigate the clinical characteristics of ALM and to evaluate their prognostic values based on a large dataset from the Central Malignant Melanoma Registry (CMMR) of the German Dermatologic Society. METHODS: The Kaplan-Meier method was used to estimate the potential influence of clinical and histological parameters on ALM disease-specific survival (DSS) curves, which were compared using the log-rank test. A Cox proportional hazards model was used to identify independent prognostic factors for DSS. RESULTS: In total, 2050 patients with ALM were identified from 58 949 patients with CM recorded by the CMMR with follow-up data. In multivariate analyses, age (P = 0·006), ulceration (P = 0·013), tumour thickness (P < 0·001) and tumour spread (P < 0·001) turned out to be significant prognostic factors for DSS in ALM whereas sex, nevus association and level of invasion were not independent factors. CONCLUSIONS: ALM has the same prognostic factors as other subtypes of melanoma. Unfavourable prognosis probably derives from the delay in diagnosis in comparison with other melanoma subtypes.
BACKGROUND:Acral lentiginous melanoma (ALM) is one of the four major subtypes in cutaneous melanoma (CM). Although ALM has a poorer prognosis than other CM subtypes, the prognostic factors associated with ALM have only been verified in small-sized cohorts because of the low incidence of ALM worldwide. OBJECTIVES: To investigate the clinical characteristics of ALM and to evaluate their prognostic values based on a large dataset from the Central Malignant Melanoma Registry (CMMR) of the German Dermatologic Society. METHODS: The Kaplan-Meier method was used to estimate the potential influence of clinical and histological parameters on ALM disease-specific survival (DSS) curves, which were compared using the log-rank test. A Cox proportional hazards model was used to identify independent prognostic factors for DSS. RESULTS: In total, 2050 patients with ALM were identified from 58 949 patients with CM recorded by the CMMR with follow-up data. In multivariate analyses, age (P = 0·006), ulceration (P = 0·013), tumour thickness (P < 0·001) and tumour spread (P < 0·001) turned out to be significant prognostic factors for DSS in ALM whereas sex, nevus association and level of invasion were not independent factors. CONCLUSIONS: ALM has the same prognostic factors as other subtypes of melanoma. Unfavourable prognosis probably derives from the delay in diagnosis in comparison with other melanoma subtypes.
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