Acral lentiginous melanoma
C. A. Ridgeway, T. J. Hieken, S. G. Ronan, D. K. Kim and T. K. Das Gupta
Department of Surgical Oncology, University of Illinois at Chicago.
OBJECTIVE: To analyze whether the histologic subtype acral lentiginous
melanoma confers independent prognostic significance. DESIGN: Case series
retrospective review. SETTING: Academic surgical practice. PATIENTS OR
OTHER PARTICIPANTS: Fifty-six patients with histologically confirmed acral
lentiginous melanoma identified from patients with malignant melanoma
consecutively treated by the faculty of the Department of Surgical Oncology
at the University of Illinois at Chicago. INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Lymph node metastases, disease-free survival, and
overall concurrent or subsequent survival. RESULTS: The average age of our
patients with acral lentiginous melanoma was 61.1 years. Thirty-four (61%)
were white, and the remaining 22 (39%) were African-American, Hispanic, or
Asian. Thirty (54%) were male and 26 (46%) were female. The primary tumor
occurred on the lower extremity in 46 (82%) of the cases and on the upper
extremity in the remaining 10 (18%). Twenty-four primary tumors (43%) were
greater than 4.00 mm thick. Analyzed by means of a logistic regression
model, the rate of lymph node metastases did not significantly differ among
patients with acral lentiginous melanoma, superficial spreading melanoma,
and nodular malignant melanoma. Furthermore, when corrected for tumor
thickness, disease-free and overall survival were the same for the three
histologic groups. Multifactorial analysis identified only thickness as a
prognostic variable for disease-free survival and overall survival.
CONCLUSIONS: Despite the greater age, diverse ethnic background, and
distinctive tumor characteristics of our patients with acral lentiginous
melanoma, this histologic subtype does not, in itself, affect the outcome
of these patients.
