Management of Primary Cutaneous Melanoma of the Hands and Feet

Rex, Jordi; Paradelo, Cristina; Mangas, Cristina; Hilari, Josep María; Fernández‐Figueras, María Teresa; Ferrándiz, Carlos

doi:10.1111/j.1524-4725.2009.01265.x

Cited by 35 publications

(40 citation statements)

References 27 publications

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“…In addition, we noticed a shorter delay for patients with melanomas located on the hands and feet, possibly because sentinel-node biopsy is sometimes performed at the same time as excision of the primary tumor in large or acral melanomas which are often surgically more complex. [17] Our study is in agreement with the results of Oude Ophius et al, since the time to sentinel-node biopsy did not prove to be an independent prognostic factor in the group of patients with a positive SLN. However, time to sentinel-node biopsy retained its significance as an independent prognostic factor for MSS after adjusting for all these variables in the multivariate analysis for patients with a negative SLN.…”

Section: Discussionsupporting

confidence: 93%

Effect of time to sentinel-node biopsy on the prognosis of cutaneous melanoma

Tejera‐Vaquerizo

Nagore

Puig

et al. 2015

European Journal of Cancer

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Instroduction In patients with primary cutaneous melanoma, there is generally a delay between excisional biopsy of the primary tumor and sentinel-node biopsy. The objective of this study is to analyze the prognostic implications of this delay. Patients and method This was an observational, retrospective, cohort study in four tertiary referral hospitals. A total of 1963 patients were included. The factor of interest was the interval between the date of the excisional biopsy of the primary melanoma and the date of the sentinel-node biopsy (delay time) in the prognosis. The primary outcome was melanoma-specific survival and disease-free survival. Results A delay time of 40 days or less (HR, 1.7; CI, 1.2 to 2.5) increased Breslow thickness (Breslow ≥2 mm, HR >3.7; CI 1.4 to 10.7), ulceration (HR 1.6; CI, 1.1 to 2.3), sentinel-node metastasis (HR, 2.9; CI, 1.9 to 4.2), and primary melanoma localized in the head or neck were independently associated with worse melanoma-specific survival (all P<0.03). The stratified analysis showed that the effect of delay time was at the expense of the patients with a negative sentinel-node biopsy and without regression. Conclusion Early sentinel-node biopsy is associated with worse survival in patients with cutaneous melanoma.

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Section: Discussionsupporting

confidence: 93%

Effect of time to sentinel-node biopsy on the prognosis of cutaneous melanoma

Tejera‐Vaquerizo

Nagore

Puig

et al. 2015

European Journal of Cancer

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“…This clinical presentation generally corresponds to in situ or minimally invasive melanoma (less than 0.5 mm in Breslow depth). 3 In more advanced stages, it is usually accompanied by nail dystrophy or can even become amelanotic, making the diagnosis more difficult. 4 Dermoscopy reveals irregular deposition of pigment globules, irregular bands of melanonychia, and micro-Hutchinson sign.…”

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confidence: 99%

Conservative surgical management of in situ subungual melanoma: long-term follow-up

Anda-Juárez

Martínez‐Velasco

Fonte-Avalos

et al. 2016

An. Bras. Dermatol.

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Subungual melanoma represents 20% of all melanomas in Hispanic population. Here, we report the outcome of 15 patients with in situ subungual melanoma treated with resection of the nail unit with a 5-mm margin without amputation, followed up for 55.93 ± 43.08 months. The most common complications included inclusion cysts and nail spicules. We found no evidence of local or distant recurrences at the last visit of our follow up. Functional outcome was good, with only one patient reporting persistent mild pain. These results support functional, non-amputative surgical management of in situ subungual melanomas.

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“…The incidence of melanoma on the hands and feet is 3-15% of all cutaneous melanomas in fair-skinned populations and varies considerably from country to country [3,4,5]. Although hand melanoma accounted for a small proportion of cutaneous melanoma in all populations, foot melanoma was the most common type in populations with pigmented skin [2].…”

Section: Introductionmentioning

confidence: 99%

“…Melanoma in an acral location deserves special consideration; it seems to have a poorer prognosis than cutaneous melanoma in other sites, in part as a result of the delay in diagnosis, but probably also due to a particular aggressiveness of the acral lentiginous melanoma (ALM) subtype [2,3,4]. The incidence of melanoma on the hands and feet is 3-15% of all cutaneous melanomas in fair-skinned populations and varies considerably from country to country [3,4,5].…”

Section: Introductionmentioning

confidence: 99%

Multiple Primary Acral Melanomas in Two Young Caucasian Patients

et al. 2014

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Background: Acral melanoma (AM) is still one of the most poorly studied melanomas. It generally presents beyond the fifth decade of life and usually is a BRAF wild-type melanoma. Objective: To report the first cases of multiple primary AM in Caucasians. Methods: Clinical, dermoscopic, pathological and molecular profiles. Results: A healthy 34- year-old male presented an in situ subungual melanoma on his finger, and 22 months later a fast-growing nodular melanoma appeared in an existing nevus on the sole. Both melanomas carried the V600E BRAF mutation. A 19-year-old female patient presented 2 in situ melanomas on different parts of her left foot within a 6-year period of time. The patients have neither familiar melanoma nor germline mutations in CDKN2A/CDK4 genes. Conclusion: Multiple AM in Caucasians is very rare. BRAF mutations are possible, especially in a high-risk set of patients with multiple nevi. Specific acral examination must be recommended since AM still suffers delayed detection.

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Management of Primary Cutaneous Melanoma of the Hands and Feet

Abstract: Survival differences between patients with AM and NAM are due to differences in already known prognostic factors, probably as a consequence of a delay in the diagnosis in these locations.

Cited by 35 publications

References 27 publications

Effect of time to sentinel-node biopsy on the prognosis of cutaneous melanoma

Effect of time to sentinel-node biopsy on the prognosis of cutaneous melanoma

Conservative surgical management of in situ subungual melanoma: long-term follow-up

Multiple Primary Acral Melanomas in Two Young Caucasian Patients

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