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Ethan Soudry¹, Haim Gutman, Meora Feinmesser

¹Department of Surgery B, Tel Aviv University, Tel Aviv, Israel.

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Summary

Acral lentiginous melanoma (ALM) and other extremity melanomas share similar survival rates, but non-acral melanomas present with thinner lesions and better outcomes. Tumor thickness, stage, and age are key survival predictors.

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Area of Science:

Dermatology
Oncology
Surgical Pathology

Background:

Acral lentiginous melanoma (ALM) is a subtype of cutaneous melanoma associated with poor patient survival.
Understanding the clinical course of ALM compared to other melanoma subtypes is crucial for improving patient outcomes.

Purpose of the Study:

To compare the clinical course and survival rates of ALM with non-ALM melanoma of the hands and feet.
To evaluate melanoma of the extremities located in nonacral sites.

Main Methods:

Retrospective analysis of 168 patients with cutaneous melanoma of the extremities treated between 1993 and 2005.
Categorization of patients into three groups: ALM (n=29), non-ALM hand/foot melanoma (n=16), and other-extremity melanoma (n=123).
Analysis of prognostic factors including tumor characteristics, lymph node status, and survival outcomes over a median follow-up of 53 months.

Main Results:

No significant differences in tumor characteristics, lymph node status, or survival were observed between ALM and non-ALM hand/foot melanoma groups.
Melanoma in other extremity locations (nonacral) showed significantly thinner lesions, fewer positive lymph nodes, and lower tumor stage.
Patients with other-extremity melanoma had significantly better disease-specific and disease-free survival compared to ALM and non-ALM groups.

Conclusions:

Cutaneous melanomas on acral sites, irrespective of histological type, are often diagnosed at advanced stages.
Factors contributing to advanced stage at diagnosis include older patient age, challenging lesion visibility, and potential biologic differences.
These factors collectively lead to reduced survival rates for acral melanomas.