Clinicopathological characteristics and prognosis in significantly thick acral lentiginous melanoma in Taiwan

Lee, Tung-Lin; Lin, Ming‐Hsien; Liao, Yu-Sheng; Liau, Jau–Yu; Sheen, Yi‐Shuan

doi:10.1016/j.jfma.2021.12.001

Cited by 3 publications

(8 citation statements)

References 28 publications

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“…37 Another study demonstrated that AM lesions with a thickness of ≥4.1 mm increased the incidence of recurrence within 1 year in 80.7% of stage I-II AM patients. 35 Interestingly, while Breslow thickness 37 and ulceration 36 did not influence the DSS of AM patients with intermediate/thick AM or stage III AM, 37 they were associated with a worse prognosis in stage I-II thin AM. 36,37 In addition, the presence of higher mitotic rate in primary AM increased the risk of recurrence over 5 years.…”

Section: Discussionmentioning

confidence: 92%

“…33 Similar to cutaneous melanoma in other anatomical locations, high Breslow thickness, ulceration, and mitotic rate were identified as factors strongly associated with the prognosis of acral melanoma. 18,21,24,[34][35][36][37] These parameters are interrelated, such that higher Breslow thickness, greater frequency of ulceration, 36 and increased mitotic rate 35 are commonly observed together. [35][36][37] Our findings are consistent with those of a series of 853 stage I-II AM cases, which showed a median Breslow thickness of 3.0 mm and 62% of tumors with ulceration.…”

Section: Discussionmentioning

confidence: 99%

“…18,21,24,[34][35][36][37] These parameters are interrelated, such that higher Breslow thickness, greater frequency of ulceration, 36 and increased mitotic rate 35 are commonly observed together. [35][36][37] Our findings are consistent with those of a series of 853 stage I-II AM cases, which showed a median Breslow thickness of 3.0 mm and 62% of tumors with ulceration. 37 Another study demonstrated that AM lesions with a thickness of ≥4.1 mm increased the incidence of recurrence within 1 year in 80.7% of stage I-II AM patients.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to cutaneous melanoma in other anatomical locations, high Breslow thickness, ulceration, and mitotic rate were identified as factors strongly associated with the prognosis of acral melanoma 18,21,24,34–37 . These parameters are interrelated, such that higher Breslow thickness, greater frequency of ulceration, 36 and increased mitotic rate 35 are commonly observed together 35–37 .…”

Section: Discussionmentioning

confidence: 99%

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Impact of clinical and histopathological characteristics on the disease‐free survival of stage I‐II acral melanoma patients

Borges de Barros Primo,

Brito Nobre,

Santos

et al. 2023

Int J Dermatology

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BackgroundAcral melanoma is rare and associated with a worse prognosis compared to cutaneous melanoma in other locations. Despite this, few studies have focused on the prognosis of acral melanoma, particularly in patients with initial clinical stage. The aim of this study was to assess the impact of clinical and histopathological characteristics on the disease‐free survival (DFS) of stage I‐II patients.MethodsWe analyzed 154 stage I‐II acral melanoma cases, all of whom underwent a review of the histopathological and clinical parameters. Patients were divided into groups based on the presence or absence of disease recurrence within 5 years. We used Cox proportional regression to analyze independent risk factors and computed DFS curves using the Kaplan–Meier method.ResultsWithin 5 years, 27.9% of patients experienced disease recurrence, with 90.4% occurring during the first 3 years. Univariate and multivariate analyses did not identify any clinical parameters with a significant influence on DFS. The DFS rate at 5 years was 72.7%. The median duration of disease recurrence after the initial diagnosis was 21 months. However, Breslow thickness, presence of ulceration, >3 mitosis/mm2, presence of tumor‐infiltrating lymphocytes (TIL), and perineural invasion were significantly associated with a decrease in time to first recurrence.ConclusionsDespite the favorable prognosis of stage I‐II acral melanoma compared with advance stage, clinical and histopathological characteristics can impact prognosis. In addition to Breslow thickness and ulceration, attention should be paid to mitotic rate, presence of TIL, and perineural invasion to optimize follow‐up of acral melanoma patients diagnosed in the initial clinical stage.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of clinical and histopathological characteristics on the disease‐free survival of stage I‐II acral melanoma patients

Borges de Barros Primo,

Brito Nobre,

Santos

et al. 2023

Int J Dermatology

View full text Add to dashboard Cite

show abstract

“…Interestingly, there are differences in the incidence of AM between men and women across ethnic groups. However, some studies did not find a significant difference regarding gender in AM [12][13][14] and there are conflicting views on the relationship between gender and AM prognosis since studies have found that gender is not an independent prognostic factor of AM [15][16][17]. In contrast, other studies have suggested that being a woman is an independent prognostic factor, presenting prolonged overall survival (OS) compared to male patients.…”

Section: Clinical Characteristicsmentioning

confidence: 99%

Clinical features, molecular pathology, and immune microenvironmental characteristics of acral melanoma

Gui

Zhang

2022

J Transl Med

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Acral melanoma (AM) has unique biology as an aggressive subtype of melanoma. It is a common subtype of melanoma in races with darker skin tones usually diagnosed at a later stage, thereby presenting a worse prognosis compared to cutaneous melanoma. The pathogenesis of acral melanoma differs from cutaneous melanoma, and trauma promotes its development. Compared to cutaneous melanomas, acral melanomas have a significantly lighter mutational burden with more copy number variants. Most acral melanomas are classified as triple wild-type. In contrast to cutaneous melanomas, acral melanomas have a suppressive immune microenvironment. Herein, we reviewed the clinical features, genetic variants, and immune microenvironmental characteristics of limbic melanomas to summarise their unique features.

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Survival benefit of sentinel lymph node biopsy in Asian melanoma patients

Hsu

Liao

Sheen

2023

Pigment Cell Melanoma Res

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Sentinel lymph node biopsy (SLNB) provides important prognostic information for early‐stage melanomas. However, statistics regarding the survival comparison between SLNB and nodal observation in Asia, where acral lentiginous melanoma (ALM) predominates, are limited. This study aimed to identify if SLNB offered survival benefits over nodal observation in early‐stage melanomas in Taiwan. The retrospective study included 227 patients who met the SLNB criteria according to the National Comprehensive Cancer Network guidelines and were treated at National Taiwan University Hospital from June 1997 to June 2021. Survival analysis was performed using Kaplan–Meier curves and Cox proportional hazards regression models. Of the study population, ALM accounted for 73.1%; 161 patients (70.9%) underwent SLNB and 66 patients (29.1%) were under nodal observation. Multivariate analysis showed significantly improved melanoma‐specific survival (hazard ratio [HR], 0.6; p = .02) in the SLNB group. Among those who underwent completion lymph node dissection (CLND), the non‐sentinel node positivity rate was 44.4%. Immediate CLND resulted in significantly longer melanoma‐specific survival and distant‐metastasis‐free survival (DMFS) compared to nodal observation. (HR, 0.2; p = .01 for melanoma‐specific survival. HR, 0.3; p = .046 for DMFS). In conclusion, SLNB may provide survival benefits of cutaneous melanoma over nodal observation in the Taiwanese population.

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Clinicopathological characteristics and prognosis in significantly thick acral lentiginous melanoma in Taiwan

Cited by 3 publications

References 28 publications

Impact of clinical and histopathological characteristics on the disease‐free survival of stage I‐II acral melanoma patients

Impact of clinical and histopathological characteristics on the disease‐free survival of stage I‐II acral melanoma patients

Clinical features, molecular pathology, and immune microenvironmental characteristics of acral melanoma

Survival benefit of sentinel lymph node biopsy in Asian melanoma patients

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