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Related Experiment Video

Updated: Jul 9, 2026

Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma
09:52

Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma

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Subungual melanoma: management considerations.

Tzeela Cohen1, Klaus J Busam, Ami Patel

  • 1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

American Journal of Surgery
|December 19, 2007
PubMed
Summary

Subungual melanoma (SM) often presents as deep lesions, particularly on the toe, leading to delayed diagnosis. Early treatment is crucial to prevent recurrence and improve outcomes for this challenging melanoma subtype.

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Area of Science:

  • Dermatology
  • Surgical Oncology
  • Melanoma Research

Background:

  • Subungual melanoma (SM) frequently presents with delayed diagnosis and deep primary lesions.
  • Breslow depth is often undetermined pre-operatively, complicating treatment planning for SM.

Purpose of the Study:

  • To analyze clinical and pathological factors of subungual melanoma.
  • To evaluate treatment outcomes and prognostic indicators for SM patients.

Main Methods:

  • Retrospective review of 49 subungual melanoma patients treated between 1992 and 2004.
  • Statistical analysis using Student t test and Kaplan-Meier survival analysis.

Main Results:

  • Most patients were female (63%), median age 66. Great toe (n=21) and thumb (n=15) were most common sites.

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  • Median Breslow depth was 2.1 mm; toe lesions were thicker and had poorer outcomes (5-year survival 40% vs 72% for finger lesions).
  • Sentinel lymph node biopsy (SLN) was positive in 17% (5/30), associated with deeper lesions and higher recurrence rates.

    • Conclusions:

    • Subungual melanoma poses distinct therapeutic challenges with frequent deep presentations, especially on toes.
    • Undertreatment of early-stage subungual melanoma is linked to increased local recurrence.
    • Prompt diagnosis and appropriate management are critical for improving subungual melanoma patient outcomes.