Improvement in survival rate of patients with acral melanoma observed in the past 22 years in Sendai, Japan

Abstract

While the incidence of malignant melanoma is much lower in Japanese than in Caucasians, the commonest site of melanoma in Japanese has been reported to be the acral regions of the limbs. The survival rate for acral and nodular melanoma observed at the Department of Dermatology, Tohoku University Hospital in Sendai, Japan from 1969 to 1990 was reviewed. Among 150 melanoma patients 125 (83%) and 17 (11%) had primary cutaneous melanoma and mucous membrane melanomas, respectively. Frequent sites for cutaneous melanomas were the sole (31%) and subungual regions (15%). Comparison of the stages of plantar melanoma at diagnosis showed that the proportion of stages III and IV decreased after 1980 with a corresponding increase in those with a tumour thickness of less than 4 mm (stage II). Concurrently, the prognosis of plantar melanoma has improved; the 5-year survival rate in each of the three periods 1969-75, 1976-80 and 1981-85 was 21, 70 and 90%, respectively. This was also the case with subungual melanoma. Such improvements in the prognosis are thought to be mainly due to early detection through the growing public awareness of this life-threatening disease. By contrast cases of nodular melanoma increased sharply after 1980. Among these, the high proportion of patients in advanced stages (stages III and IV) remained static even after 1980, with a resultant low 5-year survival rate in the above mentioned periods of 33, 38 and 18%, respectively.

Treatment and Outcomes of Melanoma in Acral Location in Korean Patients

“…Therefore, although amputation should not be recommended in general, it should be the first recommendation in cases of subungal melanomas without enough safety margins. In general, acral lentiginous melanomas are known to have poorer prognosis due to a delay in diagnosis because of the atypical locations and lack of awareness of this disease entity in the non-Caucasian populations 39-41. However, our study shows no difference in the prognosis of melanomas of the hands and feet compared to melanomas of other areas in Korean patients.…”

“…However, our study shows no difference in the prognosis of melanomas of the hands and feet compared to melanomas of other areas in Korean patients. Kato, et al41 have observed improved survival rates for patients with acral melanoma during the last 22 years and attributed this improvement to efforts by Japanese dermatologists to educate the general public. Early detection programs impact the outcome of melanoma.…”

Cutaneous melanoma in Asian‐Americans

“…Asians living in their native countries have a high incidence of acral lentiginous tumors, comprising a majority of the cutaneous melanomas diagnosed [18][19][20]22,26,34]. Whether or not other forms of cutaneous melanoma would be identified more commonly in this population with increased recognition or screening programs is unknown.…”

Comparison of negative pressure wound therapy and secondary intention healing after excision of acral lentiginous melanoma on the foot

“…Acral lentiginous melanoma represents the most common form of melanoma in darker‐pigmented individuals. Because of its acral presentation and rarity of melanoma in noncaucasian populations, it is frequently diagnosed at an advanced stage and has a worse prognosis 1–5 …”