Foot Melanoma Localized to Subungual Toe Location Portends Poorer Prognosis

Area of Science:

• Dermatology
• Surgical Oncology
• Oncology

Background:

• Melanoma of the foot is often diagnosed at advanced stages, correlating with reduced patient survival.
• Previous studies indicated that toe lesions have particularly poor prognoses.

Purpose of the Study:

• To expand on previous findings by analyzing a 10-year cohort of patients with invasive melanoma of the foot and ankle.
• To identify additional prognostic factors influencing survival in this patient population.

Main Methods:

• A retrospective analysis of 211 patients diagnosed and treated for invasive melanoma of the foot and ankle between 2007 and 2016.
• Evaluation of demographic, pathological, staging, and lesion localization data to determine associations with overall survival.
• Multivariable analysis was employed to identify independent prognostic factors.

Main Results:

• Overall survival for foot melanoma was 70.6%.
• Subungual toe melanoma showed significantly poorer survival (53.1%) compared to nonsubungual toe melanoma (60.7%).
• Breslow depth, ulceration, lymph node involvement, and subungual toe location were independently associated with poorer survival. Subungual melanomas frequently presented with deep lesions (>4.0 mm Breslow depth).

Conclusions:

• Subungual melanoma is a significant independent prognostic factor associated with advanced disease and poorer survival.
• A low threshold for biopsying suspicious lesions on the foot and toe, particularly subungual lesions, is recommended.