Melanoma in Mexico: Clinicopathologic Features in a Population with Predominance of Acral Lentiginous Subtype

Abstract

Our patients had worse prognosis compared with data from the US Surveillance, Epidemiology, and End Results database. We found male sex and ALM as independent risk factors for worse survival, in addition to known risk factors.

Acral Lentiginous Melanoma Is Associated with Certain Poor Prognostic Histopathological Factors but May Not be Correlated with Nodal Involvement, Recurrence, and a Worse Survival

“…Our findings concur with previous publications which have evaluated ALM patients in according to ethnicity (Caucasians and other ethnic groups, such as blacks, Hispanics, and Asians) in the same studies [1, 2, 4, 5, 8] and in separate studies [3, 6, 7]. In 17 population-based cancer registries, with a total number of 1,413 American subjects with histologically confirmed cases of ALM, the proportion of ALM among all melanoma subtypes was greatest in nonwhites, accounting for 36% of all melanomas in blacks, 18% in Asian/Pacific Islanders, 9% in Hispanic whites, and only 1% in non-Hispanic whites [1].…”

“…A few clinical trials focusing solely on the outcome of ALM have also been published and they share similar negative results [1, 3-5, 7]. Although its biological behavior has yet to be elucidated, ALM is in the most general terms considered to be associated with a poor prognosis.…”

“…Since ALM rarely occurs in Caucasians and it is the most common type of melanoma in people with darker skin, a large number of papers on ALM have been published from Hispanic [4, 5] and Far East countries [6, 7]. A total of 90 Colombian ALM patients (55 men and 35 women) were investigated in a retrospective study [4].…”

“…Ulceration was present in 42.2% of the lesions and about a third of them were diagnosed at advanced stages (stages III and IV). In a Mexican referral center-based study, ALM, with a prevalence of 44.1% among melanoma patients, was found to be the most common melanoma subtype [5]. The median tumor depth for ALM was 6.01 mm.…”

“…The poor prognosis of ALM, compared to other subtypes of cutaneous melanoma, has been indicated in several studies [1, 3-5, 7]. In summary, nonwhite melanoma patients (blacks, Hispanics, and Asians) had poorer survival rates than white-skinned patients.…”