Clinical Outcomes of Localized Melanoma of the Foot

Melanoma of the lower extremities: foot site is an independent risk factor for clinical outcome

“…15 Most of the data regarding melanoma arising on the foot are derived from case series, which are non-homogeneous (including subungual lesions and patients in different stage of diseases) and limited in sample size. [3][4][5][6][7] Therefore, it is still not clear whether among melanomas of the lower extremities, the ones on the foot should be considered as a separate entity with a worse prognosis.…”

“…3,4 However, most of the literature data report limited size and non-homogeneous series; therefore, these results could be misleading. Some of these studies [5][6][7] consider cutaneous melanomas together with subungual lesions, but subungual melanoma is known to be associated with a worse prognosis. 5 Moreover, the few studies that confirmed the negative independent prognostic factor of foot site in multivariate survival analyses were conducted on case series of limited size.…”

Multiple Primary Acral Melanomas in African-Americans: A Case Series and Review of the Literature

“…Although the Breslow thickness is the main indicator of prognosis regardless of clinicopathologic subtype, the categorization may still be useful because of the different predilection for sites, risk factors, natural histories, and therapeutic implications 42 . A number of population‐based data have demonstrated an association of ALM with increased age at diagnosis 30,43,44 and with poor prognosis 30,43–45 . The overall recurrence rate of acral melanoma is 11% combining all forms of treatment, whereas melanoma at nonacral sites, including the head and neck, recurs at a rate of 4.4% 46 .…”

“…42 A number of population-based data have demonstrated an association of ALM with increased age at diagnosis 30,43,44 and with poor prognosis. 30,[43][44][45] The overall recurrence rate of acral melanoma is 11% combining all forms of treatment, whereas melanoma at nonacral sites, including the head and neck, recurs at a rate of 4.4%. 46 More recent research shows that African-American race and ulceration are significant predictors of death in acral melanoma.…”

A Comparative Review of Melanocytic Neoplasms

“…8) Number of metastatic sites: this variable was not incorporated into the TNM system because of the lack of standardization of diagnostic strategies used to search for metastatic sites. 9) Site: a prognostic advantage is seen in patients with nondistal appendicular tumors, as opposed to axial (trunk, head, neck), subungual, palms, or soles, 114,227 but this disappears when tumors are controlled for thickness, age, and sex. 146 10) Mitotic count: number per millimeter 2 : high counts are indicators of a worse prognosis.…”