Subungual melanoma: a 25-year review of cases.

The purpose of this study was to evaluate subungual melanoma as a site-specific entity, to determine the influence of regional nodal involvement, and to ascertain where possible the role of histologic grading of the primary site. Thirty-three patients with subungual melanoma whose median age was 56 yr underwent treatment between 1950 and 1975. There were 11 male and 22 female patients. Forty-eight per cent of lesions were 11 male and 22 female patients. Forty-eight per cent of lesions occurred on the hand. Of 23 clinical stage I patients, seven patients underwent amputation only, while 16 patients underwent amputation and regional nodal dissection. Histologic examination of the primary tumor suggested a trend towards thicker/ulcerated lesions to be associated with metastatic melanoma in regional lymph nodes and/or death due to disease. Early survival patterns favored female patients but there was no significant difference in 10-year survival when analysed by patient sex. Clinical/pathologic stages were the most significant factors affecting long-term survival with 5- and 10-year survivals of 66% and 55% in stage I patients and 22% and 0% in stage II patients.