Lino-Silva Leonardo S, Zepeda-Najar César, Salcedo-Hernández Rosa A, Martínez-Said Héctor
1 Anatomic Pathology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
2 Surgical Oncology, Hospital Ángeles Tijuana, Tijuana, Baja California Norte, Mexico.
J Cutan Med Surg. 2019 Jan/Feb;23(1):38-43. doi: 10.1177/1203475418800943. Epub 2018 Sep 15.
: Acral lentiginous melanoma (ALM) is an aggressive variant of melanoma; the incidence, prevalence, and prognosis differ among populations. We analyzed clinicopathological features and survival in Hispanics, a population with high ALM prevalence.
: From 1144 patients with melanoma, we analyzed 715 ALMs and 429 non-ALMs from the National Referral Cancer Centre and compared survival.
: Of the ALM group, 62.8% were female; the median age was 58 years. The mean Breslow thickness was 3.56 ± 7.16 mm. ALM patients showed an estimated 5-year disease-specific survival (DSS) of 53.3%, 52.7%, and 40.8% for stage I, II, and III, respectively. For non-ALM patients, the DSS rates were 66%, 60.8%, and 48.4% for stage I, II, and III disease, respectively. Overall, the 1-, 3-, and 5-year DSS rates for patients with ALM were 85.1%, 59.4%, and 46.3%, respectively; for non-ALM patients, they were 81.3%, 64.8%, and 55.7%, respectively ( P = .168). In the multivariate analysis, factors associated with decreased DSS were high Breslow thickness, recurrence, ulceration, male sex, and advanced stage.
: The 1-, 3-, and 5-year DSS rates of patients with ALM were not statistically different from those of non-ALM patients. In addition to known adverse prognostic factors, male sex was also associated with worse survival.
肢端雀斑样痣黑色素瘤（ALM）是黑色素瘤的一种侵袭性变体；不同人群的发病率、患病率和预后有所不同。我们分析了西班牙裔人群（该人群中ALM患病率较高）的临床病理特征和生存率。
我们从1144例黑色素瘤患者中，分析了来自国家转诊癌症中心的715例ALM患者和429例非ALM患者，并比较了生存率。
在ALM组中，62.8%为女性；中位年龄为58岁。平均Breslow厚度为3.56±7.16毫米。ALM患者I期、II期和III期的估计5年疾病特异性生存率（DSS）分别为53.3%、52.7%和40.8%。对于非ALM患者，I期、II期和III期疾病的DSS率分别为66%、60.8%和48.4%。总体而言，ALM患者的1年、3年和5年DSS率分别为85.1%、59.4%和46.3%；非ALM患者的相应比率分别为81.3%、64.8%和55.7%（P = 0.168）。在多变量分析中，与DSS降低相关的因素包括Breslow厚度高、复发、溃疡、男性性别和晚期。
ALM患者的1年、3年和5年DSS率与非ALM患者在统计学上无差异。除了已知的不良预后因素外，男性性别也与较差的生存率相关。
