A retrospective study of acral melanoma that happened on foot

Abstract

Methods: The aim was to investigate the epidemiological, clinical, and prognostic features of acral melanoma (AM) that occurred on foot, and to provide associated data for further study. A retrospective study was performed on patients with malignant melanoma (MM) who were treated in our hospital from January 2015 to January 2019. The tumor site was screened by foot. Basic data (e.g., gender, age, occupation, tumor location and etiology) of eligible patients, tumor-related data (such as tumor thickness, lymph node metastasis, and systemic metastasis), surgical related data (e.g., surgical site, operation time, bleeding volume, postoperative drainage time and volume), and prognostic data (including local recurrence or metastasis) were extracted. Survival analysis was used to study event-free survival (EFS) and overall survival (OS) and factors influencing survival of patients. Results: A total of 109 patients with AM happened on foot, including 52 males and 57 females, male/female = 0.91, were involved. The patients’ age was 58.31±12.13 years old. The occupations included 69 (63.3%) of farmers, 20 (18.3%) of freelance work, 4, 10 and 6 (18.4% in total) of others, including workers, students, and retirees. Tumor locations were 19 (17.4%) of the thumbs, 9 (8.3%) of other toes, 54 (49.5%) of the inner and outer soles, 20 (18.3%) of the heels, and 7 (6.4%) of the back foot. The causes were 57 cases (52.3%) of malignant nevus, 7 cases (6.4%) of trauma stimulation, and 45 cases (41.3%) without inducement. Additionally, 29 cases (26.6%) were newly diagnosed and treated in our hospital, and 80 cases (73.4%) were previously treated in external hospitals. Symptoms of nudes or ulceration lasted for 1 to 15 months, with an average of 5.92 months. The main surgical methods are tumor (enlarged) resection, lymph nodes resection, and combined resection of tumor and lymph nodes. During the treatment, 45 patients needed additional surgery. At the last follow-up, 8 cases had tumor recurrence, 43 cases had lymph node metastasis, 29 patients (stage IV) had metastasis in vital viscera, and 12 patients died. The EFS was 16 months, and OS was 31 months on average. Univariate analysis suggested that there was a correlation between occupations and EFS, locations and OS. Conclusions: Middle-aged and elderly manual workers were found as the main population of AM that happened on foot. The tumor appeared at the weight-bearing area of the soles and heels. The proportion of metastasis was high, while the prognosis was poor. Preventive resection of precancerous lesions and early diagnosis and treatment of tumors are the primary tasks to improve the efficacy and survival of patients

A European Multicentric Investigation of Atypical Melanocytic Skin Lesions of Palms and Soles: The iDScore-PalmoPlantar Database

“…Benign aMPPLs, instead, were slightly prevalent at hypothenar–metacarpal surfaces of palms, and clearly prevalent on the plantar arch of soles. These data show that there is essentially no difference between weight-bearing/non-weight-bearing areas of the soles in terms of melanoma development, which is in line with recent literature data that excluded a causative role of walking barefoot [ 16 , 17 , 18 , 46 , 47 , 48 ]. As per palmar melanoma, reports of a trauma occurrence are too very few to derive conclusions.…”

“…We did not detect any difference in sex distribution for PP melanoma cases (51%F/49%M); this trend is, however, in line with some retrospective studies on acral melanoma patients, reporting distribution of 54%/46%M [ 46 ] and 49%/51% [ 48 ], while previous monocentric studies showed a slight female or male prevalence (e.g., M:F = 1:1.86 [ 3 ], M:F = 1:1.6, [25 M:F = 1:1.9,12 F:M = 1:1.08,26 and M:F = 1:1.712). Precisely, a similar sex distribution was found in patients with cases of early melanoma of the body, in the context of retrospective studies on atypical melanocytic lesions [ 30 , 49 ].…”