Borkowska Aneta M, Szumera-Ciećkiewicz Anna, Spałek Mateusz J, Teterycz Paweł, Czarnecka Anna M, Rutkowski Piotr Ł
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
Department of Pathology and Laboratory Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
J Clin Med. 2020 Sep 16;9(9):2996. doi: 10.3390/jcm9092996.
Cutaneous melanomas located on the acral part of extremities (hand and foot melanoma; HFM) comprise a rare group within all melanomas in Caucasians. HFM is associated with a poor prognosis. We aimed to evaluate clinicopathological features, long-term outcomes, and prognostic factors in primary HFM in Caucasians.
Medical records of all consecutive patients treated between 1997 and 2014 were revised. Patients were diagnosed with primary cutaneous melanoma at I-II clinical stage, and sentinel lymph node biopsy was conducted. The analysis was performed to define the clinicopathological factors influencing outcomes in the HFM and subungual cohort. Among 2537 consecutive patients diagnosed with primary cutaneous melanoma, 247 cases of HFM (9.7%) were found, with a median follow-up time of 7.8 years.
Median primary tumor Breslow thickness in subungual melanomas and HFMs was 4.0 mm and 3.3 mm, respectively, significantly higher than in the entire population (median 2.2 mm; < 0.01). In the HFM group, 37.6% of tumors were ulcerated. Metastases to sentinel lymph node (SLN) were found in 28.3% of HFMs. The 10-year overall survival rate in the HFM group and subungual melanomas was 48.1% and 49.3%, respectively, compared to 63.0% in non-HFM melanomas.
Our results confirm that patients with HFMs display worse overall survival compared to the entire melanoma population, with male gender and positive SLN biopsy status acting as independent negative prognostic factors.
位于四肢末端的皮肤黑色素瘤（手足黑色素瘤；HFM）在白种人的所有黑色素瘤中占比较少。HFM预后较差。我们旨在评估白种人原发性HFM的临床病理特征、长期预后及预后因素。
回顾了1997年至2014年间所有连续治疗患者的病历。患者被诊断为临床I-II期原发性皮肤黑色素瘤，并进行了前哨淋巴结活检。进行分析以确定影响HFM和甲下黑色素瘤队列预后的临床病理因素。在2537例连续诊断为原发性皮肤黑色素瘤的患者中，发现247例HFM（9.7%），中位随访时间为7.8年。
甲下黑色素瘤和HFM的原发肿瘤中位Breslow厚度分别为4.0mm和3.3mm，显著高于总体人群（中位2.2mm；P<0.01）。在HFM组中，37.6%的肿瘤发生溃疡。28.3%的HFM发现前哨淋巴结转移。HFM组和甲下黑色素瘤的10年总生存率分别为48.1%和49.3%，而非HFM黑色素瘤为63.0%。
我们的结果证实，与整个黑色素瘤人群相比，HFM患者的总生存率较差，男性性别和前哨淋巴结活检阳性状态是独立的不良预后因素。
