Subungual melanoma: A retrospective cohort of 157 cases from Brazilian National Cancer Institute

Nunes, Luiz Fernando; Mendes, Gélcio Luiz Quintella; Koifman, Rosalina Jorge

doi:10.1002/jso.25242

Cited by 20 publications

(43 citation statements)

References 32 publications

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“…The constitution percentages of different primary sites were consistent with the reports of Haugh et al and Curtin et al 12,17 With respect to age, the overall median age of the patients at time of diagnosis was 56 and the sole group had an older median/mean age than the other two groups, which is similar to another study result. 17 Nunes et al 10 analyzed 157 Brazilian AM patients; the age at diagnosis was older than ours and the age distribution between palms and nail beds was similar. This was not consistent with our comparison results.…”

Section: Discussionmentioning

confidence: 46%

“…The stage III/IV distribution for the rest 2 groups were similar. Another study, 10 however, showed that the proportion of stage III/ IV in the palm group was threefold higher than that in the nail bed group, which may be due to race variation. The overall distant metastases percentage in our study was comparable with previous literature 2, 18 but the sole population had a higher proportion of distant metastases.…”

Section: Discussionmentioning

confidence: 86%

“…Previous studies focusing on clinical, genetic and survival discrepancy across different primary sites in AM have yielded controversial results. Nunes et al 10 analyzed 529 Brazilian AM patients and reported that the clinical profiles including age, sex, stage, Breslow depth and ulceration status were not significantly different between volar and subungual melanoma. On the other hand, an analysis of 177 AM patients in Korea 11 showed that the ulceration proportion in the subungual group was higher.…”

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confidence: 99%

“…2,15 On the whole, no agreement has been reached on the clinical and survival profiles between different primary anatomical lesions. 10,16 In this study, our objective was to elucidate and summarize the clinicopathological and survival features across primary sites in AM patients based on a Chinese population.…”

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confidence: 99%

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The Clinicopathological and Survival Profiles Comparison Across Primary Sites in Acral Melanoma

Wei

et al. 2020

Ann Surg Oncol

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Background. The clinicopathological and survival profiles across primary sites in acral melanoma (AM) are still controversial and unclear. Methods. This is a multi-center retrospective study. Clinicopathological data of AM patients diagnosed between 1 January 2000 and 31 December 2017 from 6 large tertiary hospitals in China were extracted. Chi square tests were used to compare basic characteristics between primary sites of sole, palm and nail bed. Melanomaspecific survival (MSS) differences based on primary sites were compared by log-rank tests and multivariate Cox regressions were used to identify prognostic factors for MSS. Results. In total, 1157 AM patients were included. The sole group had a more advanced initial stage, deeper Breslow thickness, higher recurrence rate and distant metastases risk (all P \ 0.05). The proportion of age \ 65 years and ulceration were statistically lower in nail bed and palm groups, respectively. A total of 294 patients underwent sentinel lymph node biopsy and rates of positive SLN status had no statistical difference across primary sites. Among 701 patients with genetic profiles, the mutational frequency of BRAF, C-KIT, and PDGFRA were similar except for NRAS (higher in sole group, P = 0.0102). The median MSS of sole, nail bed and palm patients were 65.0 months, 112.0 months, and not reached, respectively (log-rank P = 0.0053). In multivariate analyses, primary site, initial stage, ulceration and recurrence were the prognostic factors for MSS in overall population, but the statistical significance varied over primary sites. Conclusions. Substantial clinicopathological and survival heterogeneities exist across different primary sites in the AM population. Sole melanoma has worse prognosis compared with palm and nail bed subtypes. Melanoma is a malignancy with a steadily increasing incidence worldwide. Acral melanoma (AM) is a term referring to the melanoma affecting soles, palms, and nail beds. 1 It is documented as the least common subtype in Caucasians but constitutes up to 50-75% in populations of color. 2-5

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 86%

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confidence: 99%

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confidence: 99%

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The Clinicopathological and Survival Profiles Comparison Across Primary Sites in Acral Melanoma

Wei

et al. 2020

Ann Surg Oncol

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“…An older German trial calculated a 5 year survival rate of 57% for SUM of the hand and 48% for tumors on the feet (Paul, Kleiner, & Bödeker, ). A recent large trial from Brazil observed 5 year OS and DFS rates of 61.0% and 41.8%, respectively (Nunes et al, ). In our series of patients, the median relapse‐free survival was 56 months and the median overall survival was 112.5 months.…”

Section: Discussionmentioning

confidence: 99%

Subungual melanoma: A single center series from Dresden

Wollina

Tempel

Hansel

2019

Dermatologic Therapy

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Subungual melanoma (SUM) is a rare subtype in Caucasians. Histologically, most tumors are of the acrolentiginous type (ALM). This is a retrospective analysis of the years 2002–2019 at a certified skin cancer center. We observed 12 SUM patients with a median age of 76 years, seven men and five women (0.6% of all melanomas). The delay of diagnosis reached from 30 years to several months. Hallux and thumb were the most affected localizations. The dominant histologic type was ALM. Clinical symptoms were nail plate destruction (90.9%), bleeding (50.0%), pigmentation of the nail plate (33.3%), and a positive Hutchinson sign (25.0%). All tumors were treated surgically with three‐dimensional margin control. In six patients, amputation was performed. Median relapse‐free survival and overall survival were (56 ± 73.5) months and (112.5 ± 135.1) months, respectively. SUM is rare among Caucasian patients. Nail plate pigmentation and Hutchinson sign were not frequent. Amelanotic ALM with nail plate destruction was the dominant presentation in our series. Dermoscopy is of limited value for amelanotic subungual tumors. Early biopsy of unusual or treatment resistant nail disorders is recommended.

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