Yonsei Med J.  2010 Jul;51(4):562-568. 10.3349/ymj.2010.51.4.562.

Treatment and Outcomes of Melanoma in Acral Location in Korean Patients

Affiliations
  • 1Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea. kychung@yuhs.ac

Abstract

PURPOSE
A retrospective study was conducted to review the treatment and outcomes of mainly melanomas in acral location in a single institution in Korea, and to evaluate the prognostic significance of anatomic locations of the tumor.
MATERIALS AND METHODS
A retrospective review was completed on 40 patients between 2001 and 2006 to obtain pertinent demographic data, tumor data, treatment characteristics, and follow-up data.
RESULTS
Forty melanoma patients were identified and analyzed. Of these, 18 were male and 22 were female patients and the mean age at the time of diagnosis was 55.9 years. Of the tumors, 65% were located on the hands and feet with acral lentiginous melanoma being the most common histological subtype. Univariate analysis for the overall melanoma survival revealed that the thickness of the tumor and the clinical stage have prognostic significances. The most significant factor as analyzed by a multivariate analysis was shown to be the advanced clinical stage. Acral melanomas did not show statistically significant differences in the age at diagnosis, thickness of the tumor, stage, ulceration, and survival rates compared to non-acral melanomas. There was also no significant difference in the survival rate between the patients treated by amputation versus wide local excision in acral melanomas.
CONCLUSION
In Korean melanoma patients, thickness and advanced stages are significant factors for poorer prognosis. However, the location of melanoma did not have a significant prognostic value. In treating the melanomas in acral location, local wide excisions resulted in a similar prognosis compared to amputations.

Keyword

Melanoma; acral locations; prognosis; treatment

Figure

  • Fig. 1 Distribution of cutaneous melanoma by age.

  • Fig. 2 Survival curves by stages. Advanced stages had poorer prognosis (p < 0.05).

  • Fig. 3 Survival curves of melanoma in acral location by treatment method (p = 0.39).


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Clinical Outcomes of Immune Checkpoint Blocker Therapy for Malignant Melanoma in Korean Patients: Potential Clinical Implications for a Combination Strategy Involving Radiotherapy
Jeongshim Lee, Jee Suk Chang, Mi Ryung Roh, Minkyu Jung, Choong-Kun Lee, Byung Ho Oh, Kee Yang Chung, Woong Sub Koom, Sang Joon Shin
Cancer Res Treat. 2020;52(3):730-738.    doi: 10.4143/crt.2019.598.


Reference

1. Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. CA Cancer J Clin. 2002. 52:23–47.
2. Dooley TP. Recent advances in cutaneous melanoma oncogenesis research. Oncol Res. 1994. 6:1–9.
3. Chen YJ, Wu CY, Chen JT, Shen JL, Chen CC, Wang HC. Clinicopathologic analysis of malignant melanoma in Taiwan. J Am Acad Dermatol. 1999. 41:945–949.
Article
4. Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1998. 83:1664–1678.
Article
5. Luk NM, Ho LC, Choi CL, Wong KH, Yu KH, Yeung WK. Clinicopathological features and prognostic factors of cutaneous melanoma among Hong Kong Chinese. Clin Exp Dermatol. 2004. 29:600–604.
Article
6. Ishihara K, Saida T, Yamamoto A. Japanese Skin Cancer Society Prognosis and Statistical Investigation Committee. Updated statistical data for malignant melanoma in Japan. Int J Clin Oncol. 2001. 6:109–116.
Article
7. Lee MW, Koh JK, Kwon KS, Kim NI, Kim SW, Kim SN, et al. Clinical and histopathological study of cutaneous melanoma in Korea. Korean J Dermatol. 2003. 41:43–47.
8. Moon SE, Cho KH, Hwang JH, Kim JA, Youn JI. A statistical study of cutaneous malignant tumors. Korean J Dermatol. 1998. 36:7–15.
9. Hemmings DE, Johnson DS, Tominaga GT, Wong JH. Cutaneous melanoma in a multiethnic population: is this a different disease? Arch Surg. 2004. 139:968–972.
10. Balch CM, Cascinelli N. The new melanoma staging system. Tumori. 2001. 87:S64–S68.
Article
11. Cormier JN, Xing Y, Ding M, Lee JE, Mansfield PF, Gershenwald JE, et al. Ethnic differences among patients with cutaneous melanoma. Arch Intern Med. 2006. 166:1907–1914.
Article
12. Jang KA, Kim JH, Choi JH, Sung KJ, Moon KC, Koh JK. A Clinico-histopathological study of malignant melanoma. Korean J Dermatol. 2000. 38:1435–1443.
13. Park KD, Lee SJ, Lee WJ, Kim DW, Chung HY, Cho BC. Clinicopathological features of cutaneous malignant melanoma. Korean J Dermatol. 2007. 45:149–158.
14. Lee DH, Kim YC, Cho SH, Lee MG. Clinicopathologic analysis of malignant melanoma. Korean J Dermatol. 2002. 40:914–923.
15. Ries LA, Wingo PA, Miller DS, Howe HL, Weir HK, Rosenberg HM, et al. The annual report to the nation on the status of cancer, 1973-1997, with a special section on colorectal cancer. Cancer. 2000. 88:2398–2424.
Article
16. Boyle P, Maisonneuve P, Doré JF. Epidemiology of malignant melanoma. Br Med Bull. 1995. 51:523–547.
Article
17. Tsai T, Vu C, Henson DE. Cutaneous, ocular and visceral melanoma in African Americans and Caucasians. Melanoma Res. 2005. 15:213–217.
Article
18. Morton DL, Davtyan DG, Wanek LA, Foshag LJ, Cochran AJ. Multivariate analysis of the relationship between survival and the microstage of primary melanoma by Clark level and Breslow thickness. Cancer. 1993. 71:3737–3743.
Article
19. Garbe C, Büttner P, Bertz J, Burg G, d'Hoedt B, Drepper H, et al. Primary cutaneous melanoma. Identification of prognostic groups and estimation of individual prognosis for 5093 patients. Cancer. 1995. 75:2484–2491.
Article
20. Vollmer RT. Malignant melanoma. A multivariate analysis of prognostic factors. Pathol Annu. 1989. 24(Pt 1):383–407.
21. Breslow A. Tumor thickness, level of invasion and node dissection in stage I cutaneous melanoma. Ann Surg. 1975. 182:572–575.
22. Bevilacqua RG, Coit DG, Rogatko A, Younes RN, Brennan MF. Axillary dissection in melanoma. Prognostic variables in node-positive patients. Ann Surg. 1990. 212:125–131.
23. Hu S, Ma F, Collado-Mesa F, Kirsner RS. UV radiation, latitude, and melanoma in US Hispanics and blacks. Arch Dermatol. 2004. 140:819–824.
24. Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, et al. Cancer statistics, 2005. CA Cancer J Clin. 2005. 55:10–30.
25. Rhodes AR, Weinstock MA, Fitzpatrick TB, Mihm MC Jr, Sober AJ. Risk factors for cutaneous melanoma. A practical method of recognizing predisposed individuals. JAMA. 1987. 258:3146–3154.
26. Holly EA, Aston DA, Cress RD, Ahn DK, Kristiansen JJ. Cutaneous melanoma in women. I. Exposure to sunlight, ability to tan, and other risk factors related to ultraviolet light. Am J Epidemiol. 1995. 141:923–933.
27. Elwood JM. Melanoma and sun exposure. Semin Oncol. 1996. 23:650–666.
28. Gloster HM Jr, Neal K. Skin cancer in skin of color. J Am Acad Dermatol. 2006. 55:741–760.
29. McCredie M, Coates MS, Ford JM. Cancer incidence in migrants to New South Wales from England, Wales, Scotland and Ireland. Br J Cancer. 1990. 62:992–995.
Article
30. Cooke KR, Fraser J. Migration and death from malignant melanoma. Int J Cancer. 1985. 36:175–178.
Article
31. Titus-Ernstoff L. An overview of the epidemiology of cutaneous melanoma. Clin Plast Surg. 2000. 27:305–316. vii
32. Halder RM, Bridgeman-Shah S. Skin cancer in African Americans. Cancer. 1995. 75:667–673.
Article
33. Stevens NG, Liff JM, Weiss NS. Plantar melanoma: is the incidence of melanoma of the sole of the foot really higher in blacks than whites? Int J Cancer. 1990. 45:691–693.
Article
34. Kuchelmeister C, Schaumburg-Lever G, Garbe C. Acral cutaneous melanoma in caucasians: clinical features, histopathology and prognosis in 112 patients. Br J Dermatol. 2000. 143:275–280.
Article
35. Wells KE, Reintgen DS, Cruse CW. The current management and prognosis of acral lentiginous melanoma. Ann Plast Surg. 1992. 28:100–103.
Article
36. Tseng JF, Tanabe KK, Gadd MA, Cosimi AB, Malt RA, Haluska FG, et al. Surgical management of primary cutaneous melanomas of the hands and feet. Ann Surg. 1997. 225:544–550.
Article
37. Daly JM, Berlin R, Urmacher C. Subungual melanoma: a 25-year review of cases. J Surg Oncol. 1987. 35:107–112.
Article
38. Moehrle M, Metzger S, Schippert W, Garbe C, Rassner G, Breuninger H. "Functional" surgery in subungual melanoma. Dermatol Surg. 2003. 29:366–374.
Article
39. Franke W, Neumann NJ, Ruzicka T, Schulte KW. Plantar malignant melanoma--a challenge for early recognition. Melanoma Res. 2000. 10:571–576.
40. Bennett DR, Wasson D, MacArthur JD, McMillen MA. The effect of misdiagnosis and delay in diagnosis on clinical outcome in melanomas of the foot. J Am Coll Surg. 1994. 179:279–284.
41. Kato T, Suetake T, Sugiyama Y, Tanita Y, Kumasaka K, Takematsu H, et al. Improvement in survival rate of patients with acral melanoma observed in the past 22 years in Sendai, Japan. Clin Exp Dermatol. 1993. 18:107–110.
Article
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