Acral lentiginous melanoma—Population, treatment, and survival using the NCDB from 2004 to 2015

Bian, Shelly X.; Hwang, Larn; Hwang, J.; Ragab, Omar; In, Gino K; Peng, David H.; Lin, Eugene

doi:10.1111/pcmr.12999

Cited by 12 publications

(22 citation statements)

References 55 publications

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Section: Discussionsupporting

confidence: 93%

“…Some studies conducted on the white race reported a clear prevalence of ALM in females. 11,12 However, our study did not find any significant differences in gender predominance, which is consistent with the majority of previous research. 13 Most authors believe that the average age at diagnosis of ALM is higher compared to other melanoma types, primarily due to postprognosis and misdiagnosis.…”

Section: Discussionsupporting

confidence: 93%

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Acral Lentiginous Melanoma: A Clinicoprognostic Study of 149 Cases at a Single Institution

Zheng,

Wu,

2023

The American Surgeon™

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Objective The objective of this study is to investigate the epidemiological features, clinical characteristics, and pathological characteristics of acral lentiginous melanoma (ALM) and identify prognostic factors. Methods A total of 149 patients diagnosed with ALM between August 2008 and December 2019 at the National Cancer Center (NCC) of China were retrospectively analyzed. Follow-up data on patient survival status were collected. Survival curves were generated using the Kaplan-Meier method, and statistical significance was assessed using the log-rank test. Additionally, a Cox proportional hazards model was constructed to identify prognostic factors. Results All patients included in this study were of Chinese ethnicity, with an average age of 52.4 ± 14.8 years (range, 15-80 years) at the time of diagnosis. No gender predilection or genetic susceptibility was observed. The plantar region was the most frequently affected site among primary lesions. Notably, only 17 (11.4%) patients reported a history of trauma. Statistical analysis revealed that a lesion duration of ≤2.5 years, Breslow thickness >4.0 mm, high mitotic rate (>6 mm−2), presence of vascular invasion, and regional lymph node metastasis were identified as independent prognostic factors. Conclusion Our findings indicate that a lesion duration of ≤2.5 years, Breslow thickness >4.0 mm, high mitotic rate (>6 mm−2), presence of vascular invasion, and regional lymph node metastasis are significantly associated with a poorer prognosis for patients with ALM.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Acral Lentiginous Melanoma: A Clinicoprognostic Study of 149 Cases at a Single Institution

Zheng,

Wu,

2023

The American Surgeon™

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“…In our study, we found the relationship between high expression of Ki-67 and melanoma thickness. Thus, the previous findings of the correlations of Ki-67 expression and tomor size in various solid cancers are in accordance with the present study.A recent study showed that melanoma tumor thickness is strongly associated with poor 5-year OS (33). Therefore, the high expression of KI-67 indicates the poor prognosis of melanoma patients, which may be related to tumor thickness.…”

Section: Discussionmentioning

confidence: 99%

Prognostic and Clinicopathological Value of Ki-67 in Melanoma: A Meta-Analysis

et al. 2021

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BackgroundThe prognostic and clinicopathological value of Ki-67 in melanoma is controversial. The purpose of this meta-analysis was to determine the prognostic role of Ki-67 in melanoma patients.Materials and MethodsThe PubMed, Cochrane Library, Web of Science, and Embase databases were searched systematically up to April 9, 2021. We calculated the pooled hazard ratios (HRs) and 95% confidence intervals (CIs) to determine the relationship between Ki-67 overexpression and survival outcomes. We also calculated the combined odds ratios (ORs) and 95% CIs to determine the relationship between Ki-67 expression levels and clinicopathologic parameters. All data were statistically analyzed by Stata 11.0.ResultsA total of 10 studies involving 929 patients were included in our meta-analysis. The pooled HR showed that Ki-67 overexpression was connected with poor overall survival rates (HR=2.92, 95% CI=2.17-3.91, p<0.000). However, there was no correlation between Ki-67 overexpression and the PFS (HR=0.999, 95% CI =0.958-1.041, P =0.958; I2 = 21.80%, P =0.258) or RFS (HR=1.14, 95% CI = 0.42-3.11, P =0.993; I2 = 85.00%, P =0.01) rates. Ki-67 expression levels were associated with tumor thickness, but not sex, location, ulceration or vascular invasion.ConclusionKi-67 is a useful poor prognostic indicator for melanoma patients.

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“…42 Acral lentiginous melanoma has an unclear etiology thought to be distinct among CMMs, with hypothesized environmental factors including trauma and chemical exposures. [43][44][45][46] Given the unique mutational landscape of ALM tumors, with their much lower incidence of BRAF mutations and increased incidence of KIT and CDK gene mutations compared with UV-related CMMs, ALM may have a particular proclivity toward nonstepwise regional metastasis. [15][16][17][18] This has notable implications for using traditional histopathologic adverse features in the diagnostic and treatment algorithm for ALM.…”

Section: Discussionmentioning

confidence: 99%

“…This has notable implications for using traditional histopathologic adverse features in the diagnostic and treatment algorithm for ALM. An alternative hypothesis for this association is that, owing to ALM's relatively high rate of resection with positive margins, reported Breslow depths may underestimate the true invasiveness of such tumors …”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy Positivity in Patients With Acral Lentiginous and Other Subtypes of Cutaneous Melanoma

2022

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IMPORTANCE Acral lentiginous melanoma (ALM) is a rare subtype of malignant melanoma typically occurring on the palmar and plantar surfaces. Although it has distinctive genetic, prognostic, and behavioral characteristics relative to cutaneous melanomas overall, owing to its rarity, treatment is largely guided by data extrapolated from more common subtypes. Although sentinel lymph node (SLN) status has been shown to be a significant prognostic factor for ALM, the independent effect of ALM-subtype disease on the likelihood of SLN positivity and the stage-specific positivity rates for ALM are not well characterized.OBJECTIVE To evaluate the association of ALM with SLN status as well as to characterize the clinical stage-specific rates of SLN positivity for ALM based on the AJCC Cancer Staging Manual, 8th edition (AJCC-8). DESIGN, SETTING, AND PARTICIPANTSThe National Cancer Database (NCDB) includes all reportable cases from Commission on Cancer accredited facilities and represents approximately 50% of all newly diagnosed melanoma cases in the US. This retrospective cohort study included cases of AJCC-8 clinical stage I to II melanomas from the NCDB diagnosed from 2012 to 2015. The analysis took place between April 2021 and September 2021.EXPOSURES Melanoma histopathologic subtype. MAIN OUTCOMES AND MEASURES Sentinel lymph node status. RESULTSWe identified 60 148 patients with malignant melanomas, 959 of whom had ALM-subtype disease. Among patients in the cohort, 25 550 (42.5%) were women and the mean (SD) age was 64 (16) years. Multivariable logistic regression controlling for demographic and histopathologic characteristics revealed that ALM was independently associated with the highest risk for SLN positivity among included subtypes (vs superficial spreading melanoma: odds ratio, 1.91; 95% CI, 1.59-2.28). Subgroup analysis by AJCC clinical stage demonstrated that ALM was independently associated with the highest risk for SLN positivity for both stage IB and II disease. The rate of SLN positivity for patients with stage IB and II ALM was 18.39% (95% CI, 13.82%-24.03%) and 39.53% (34.98%-44.26%), respectively. CONCLUSIONS AND RELEVANCEIn this cohort study ALM was independently associated with SLN positivity and had relatively high positivity rates at clinical stage IB and II. This suggests that SLNB should be encouraged for all patients with clinical stage IB and II ALM, and such patients should receive appropriate counseling about the higher regional metastatic risk of their cancers. Future work with a larger cohort is required to elucidate the risk of SLN positivity for stage IA ALM.

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Acral lentiginous melanoma—Population, treatment, and survival using the NCDB from 2004 to 2015

Cited by 12 publications

References 55 publications

Acral Lentiginous Melanoma: A Clinicoprognostic Study of 149 Cases at a Single Institution

Acral Lentiginous Melanoma: A Clinicoprognostic Study of 149 Cases at a Single Institution

Prognostic and Clinicopathological Value of Ki-67 in Melanoma: A Meta-Analysis

Sentinel Lymph Node Biopsy Positivity in Patients With Acral Lentiginous and Other Subtypes of Cutaneous Melanoma

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