Department of Medical Oncology, Institute of Oncology, University of Istanbul, Istanbul, Turkey.
J Dermatolog Treat. 2022 May;33(3):1630-1637. doi: 10.1080/09546634.2021.1877248. Epub 2021 Feb 15.
The anatomic site of primary melanoma is significantly correlated with survival, and extremity melanomas have better prognosis than trunk or head and neck melanomas.
The aim of this study was to review and evaluate the prognostic factors and survival outcomes associated with both upper and lower extremity melanomas.
A total of 524 limb-located melanomas were analyzed retrospectively.
Lower extremity melanomas were predominant in number and feet/toes melanomas were more frequently found in the elderly. Acral lentiginous melanomas were found to affect more frequently lower limbs and showed mainly distal distributions for both limbs. However, acral melanomas were more often ulcerated and they were more frequently BRAF wild-type melanomas associated with significant lymphovascular invasion. Foot and toe melanomas relapsed more frequently than leg melanomas. The 5-year overall survival rates for upper and lower limbs were the same, 62%. The finger ( = .0001) and toe ( = .005) melanomas had worse overall survivals than arm and leg melanomas, respectively. Both overall and disease-free survivals of acral melanoma patients were found worse than those of nonacral melanoma patients, = .0001 and = .001 respectively. Despite not having adjusted by Breslow, ulceration and nodal involvement status, acral location per se could be associated with poorer outcome in our retrospective study.
Even though they were not found to be correlated with major predictors of poor prognosis, acral melanomas significantly predict poor survival.
原发性黑素瘤的解剖部位与生存显著相关，肢端黑素瘤的预后优于躯干或头颈部黑素瘤。
本研究旨在回顾和评估与上肢和下肢黑素瘤相关的预后因素和生存结果。
回顾性分析了 524 例肢体黑素瘤。
下肢黑素瘤数量较多，足部/脚趾黑素瘤多见于老年人。肢端雀斑样黑素瘤更常累及下肢，且主要分布于四肢远端。然而，肢端黑素瘤更容易发生溃疡，并且更常为 BRAF 野生型黑素瘤，与显著的淋巴血管侵犯相关。足部和脚趾黑素瘤的复发率高于腿部黑素瘤。上肢和下肢的 5 年总生存率相同，为 62%。手指（ = .0001）和脚趾（ = .005）黑素瘤的总生存率明显低于手臂和腿部黑素瘤，分别为。肢端黑素瘤患者的总生存和无病生存均较非肢端黑素瘤患者差（ = .0001 和 = .001）。尽管未通过 Breslow 调整，但溃疡和淋巴结受累状态，肢端位置本身可能与我们的回顾性研究中的不良预后相关。
即使肢端黑素瘤与不良预后的主要预测因素无关，但它们显著预示着较差的生存。
