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Prognosis of Acral Melanoma: A Series of 281 Patients

  • Melanomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Acral melanoma (AM) is an unusual malignancy with poor survival. This study defines a cohort of patients, treated at a single institution, and the factors associated with survival and comparison with nonacral cutaneous melanoma (NACM).

Methods

All patients with AM presenting from 1995 to 2010 were identified from a prospectively maintained database. Analysis of clinicopathologic features of AM associated with disease-specific survival (DSS) was performed. A stratified, stage-matched survival analysis compared the outcome of 281 acral to 843 extremity NACM patients.

Results

A total of 281 AM patients (170 volar, 111 subungual) were identified. Pathologic stage (p < 0.001), ulceration (p < 0.001), Breslow thickness (p < 0.001), and a positive sentinel lymph node (p < 0.001) were found to be poor prognostic indicators associated with DSS. In stage-matched analysis, AM had a worse DSS compared with NACM (hazard ratio 1.8; 95 % CI 1.2–2.7; p < 0.01).

Conclusions

This study represents the largest, single-institution series describing the characteristics and outcomes of AM. AM tumors exhibit aggressive histopathologic features associated with a poorer survival outcome. AM patients have an inferior survival than extremity NACM when matched for stage, perhaps reflecting inherent alterations in tumor biology. This warrants further investigation into the differences between acral and cutaneous melanoma.

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Acknowledgment

The authors thank Kita Bogatch and the Melanoma Disease Management Team for their significant contributions to this study.

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Authors and Affiliations

  1. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Danielle M. Bello MD, Mary S. Brady MD, Daniel G. Coit MD & Charlotte E. Ariyan MD, PhD

  2. Department of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Richard D. Carvajal MD

  3. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Joanne F. Chou MPH & Katherine S. Panageas DrPH

Authors
  1. Danielle M. Bello MD
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  2. Joanne F. Chou MPH
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  3. Katherine S. Panageas DrPH
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  4. Mary S. Brady MD
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  5. Daniel G. Coit MD
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  6. Richard D. Carvajal MD
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  7. Charlotte E. Ariyan MD, PhD
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Corresponding author

Correspondence to Charlotte E. Ariyan MD, PhD.

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Bello, D.M., Chou, J.F., Panageas, K.S. et al. Prognosis of Acral Melanoma: A Series of 281 Patients. Ann Surg Oncol 20, 3618–3625 (2013). https://doi.org/10.1245/s10434-013-3089-0

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  • DOI: https://doi.org/10.1245/s10434-013-3089-0

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