Melanoma arising under the nail

Papachristou, Dimitrios N.; Fortner, Joseph

doi:10.1002/jso.2930210405

Cited by 52 publications

(20 citation statements)

References 7 publications

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“…Long delay with a duration ranging from 1 to 3.7 years in diagnosis of AM was described in the most representative reports1922232425. Many factors seem to contribute to the postponement of diagnosis: elder patients, hidden site, frequent lack of pigmentation, lack of recognition and misdiagnosis by dermatologists sometimes.…”

Section: Discussionmentioning

confidence: 99%

Acral Melanoma in Chinese: A Clinicopathological and Prognostic Study of 142 cases

Dai

Kong

et al. 2016

Sci Rep

111

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Acral melanoma (AM), as a peculiar subgroup of melanoma, is rare in Caucasians but has higher incidence in Asians. Large series of study on AM with clinicopathological features and prognostic factors is still limited, especially in Asian population. We retrospectively collected clinical, pathological and follow-up data of 142 AM cases. All patients were Chinese, with the age ranging from 24 to 87 years (mean 62.0; median 62.0). The Breslow thickness of primary lesions ranged from 0.6 to 16.3 mm (mean 4.9; median 3.7). 85.9% of the patients had acral lentiginous histologic subtype. Plantar was the most frequently involved site, followed by heels. Statistically, duration of the lesion before diagnosis (≤2.5 years), Breslow thickness >4.0 mm (T4), high mitotic index (>15 mm−2), presence of vascular invasion, regional lymph node metastasis at diagnosis and pathologic stage (II/III/IV) were found to be independent prognostic factors in both univariate and multivariate analyses. The prognosis of AM in Chinese is extremely poor. Our 5- and 10-year disease-specific survival (DSS) rates were 53.3% and 27.4%, respectively. Therefore, AM in Asians represents a more biologically aggressive melanoma subtype and is thought to carry a worse prognosis when compared with other races or cutaneous melanomas in other anatomic sites.

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Section: Discussionmentioning

confidence: 99%

Acral Melanoma in Chinese: A Clinicopathological and Prognostic Study of 142 cases

Dai

Kong

et al. 2016

Sci Rep

111

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“…This difficulty was underscored by Papachristou and Fortner, who found that 42% of the primary-care physicians they studied did not diagnose this cancer properly. 16 The difficulty in making the diagnosis of subungual melanoma and the subsequent delay in proper treatment are factors likely to contribute to the preponderance of advanced lesions seen at initial presentation.3" 7 20 In this study, a quarter of the patients presented with either lymph-node or distant metastasis, 74% of the tumors were more than 1.5 mm thick, and 61% of the melanomas had invaded to Clark's level IV or V. These factors (stage, thickness, and level of invasion) are important prognostic parameters in patients with subungual and other melanomas.2025 The contributions of these variables were also significant (or close to significant) for predicting overall survival on univariate analysis in the study. In addition, we observed shorter survival in older patients and those whose tumors were ulcerated or had invaded the underlying bone.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management and Prognostic Factors in Patients with Subungual Melanoma

et al. 1994

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“…After diagnosis of the melanoma, the affected digit must be amputated promptly. Confirming a previous report,17) most studies of subungual melanoma have used amputation with or without lymph node dissection, yielding 5-year survival rates of 16% to 32%,22,23) whereas others using amputation with lymph node dissection or regional limb perfusion have reported 5-year survival rates of 25% to 32%, with minimal morbidity and no mortality 24,25). In addition to amputation, most patients underwent lymph node dissection and regional limb perfusion.…”

Section: Discussionmentioning

confidence: 56%

Treatment Outcomes of Advanced Stage Malignant Melanoma in Hand and Foot after Amputation in Korean Patients

Cho

Jung

2013

Clin Orthop Surg

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BackgroundA retrospective study was conducted to review the overall survival and treatment outcomes of high grade melanoma in the extremity to explore the clinical features of malignant melanoma of the hand and foot, and the therapeutic efficacies and survival rate after amputation.MethodsThe clinical data of 30 patients with malignant melanoma of the hand and foot (confirmed by pathological examination), who were admitted and treated in our hospital between 2001 and 2010, were analyzed retrospectively. We analyzed variables affecting overall and disease-free survival.ResultsThirty patients (18 men and 12 women) treated with an amputation procedure for malignant melanoma in the hand or foot constituted the study cohort. The average age of the patients at the time of diagnosis was 58.7 years. Univariate analysis for overall melanoma survival revealed that diagnosis at over 70 years of age, postoperative lymph node metastasis, and location of the tumor were significant prognostic factors. And on the Kaplan-Meier survival curve, old age, American Joint Committee on Cancer stage and postoperative lymph node metastasis showed statistically significant differences in the 5-year survival rate. Also, amputation with aggressive lymph node dissection showed improved long term survival in advanced stage melanoma.ConclusionsIn Korean melanoma patients, for the treatment of high grade melanomas in the extremities after amputation, early diagnosis and postoperative follow-up for evaluation of lymph node metastasis are critical factors for long-term survival. And by performing lymph node dissection during amputation, we may improve the survival rate in advanced stage melanoma patients.

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Melanoma arising under the nail

Cited by 52 publications

References 7 publications

Acral Melanoma in Chinese: A Clinicopathological and Prognostic Study of 142 cases

Acral Melanoma in Chinese: A Clinicopathological and Prognostic Study of 142 cases

Surgical Management and Prognostic Factors in Patients with Subungual Melanoma

Treatment Outcomes of Advanced Stage Malignant Melanoma in Hand and Foot after Amputation in Korean Patients

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