Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Indian J Dermatol Venereol Leprol. 2021;87(4):498-508. doi: 10.25259/IJDVL_601_19.
There are limited data regarding the difference in progression pattern between acral melanoma and nonacral melanoma.
The objectives of this study were to compare the progression pattern between acral and nonacral melanoma and evaluate its impact on clinical outcomes.
Clinical and histopathological features, survival outcomes and prognostic factors of 492 patients with acral melanoma or nonacral melanoma were retrospectively evaluated using the Asan Medical Center database.
The male-to-female ratio and the mean age was 1:0.92 and 60.2 years for acral melanoma (n = 249), and 1:0.85 and 58.4 years for nonacral melanoma (n = 243), respectively. The demographic difference was not significant. Although prediagnosis duration was longer and the advanced stage was more common in acral melanoma than that in nonacral melanoma, the vertical growth phase was more common in nonacral melanoma than that in acral melanoma, whereas, the horizontal diameter is longer in acral melanoma than that in nonacral melanoma. Dissemination to lymph nodes was more common in acral melanoma than that in nonacral melanoma. Lymph node involvement was associated with deeper Breslow thickness in nonacral melanoma but not in acral melanoma. The degree of correlation of prediagnosis duration with horizontal diameter was remarkable in acral melanoma, but with Breslow thickness in nonacral melanoma. Overall survival was worse in acral melanoma than that in nonacral melanoma. The prognostic value of Breslow thickness was more remarkable in nonacral melanoma than that in acral melanoma.
This study is a retrospective, single-center design.
Acral melanoma has a longer radial growth phase compared with nonacral melanoma. However, acral melanoma is commonly associated with lymph node dissemination which contributed to worse survival in acral melanoma than nonacral melanoma.
肢端黑色素瘤和非肢端黑色素瘤的进展模式存在差异，但相关数据有限。
本研究旨在比较肢端和非肢端黑色素瘤的进展模式，并评估其对临床结局的影响。
回顾性分析 492 例肢端黑色素瘤或非肢端黑色素瘤患者的临床和组织病理学特征、生存结局和预后因素，数据来自于首尔峨山医学中心数据库。
肢端黑色素瘤组（n=249）男女比为 1:0.92，平均年龄为 60.2 岁；非肢端黑色素瘤组（n=243）男女比为 1:0.85，平均年龄为 58.4 岁。两组间的性别和年龄差异无统计学意义。虽然肢端黑色素瘤的诊断前时间较长，且更常处于晚期，但垂直生长阶段在非肢端黑色素瘤中更为常见，而非肢端黑色素瘤的水平直径较长。肢端黑色素瘤更常发生淋巴结转移。淋巴结受累与非肢端黑色素瘤的 Breslow 厚度更深有关，而非肢端黑色素瘤的 Breslow 厚度更深与淋巴结受累有关。肢端黑色素瘤中诊断前时间与水平直径的相关性较强，而非肢端黑色素瘤中与 Breslow 厚度的相关性较强。与非肢端黑色素瘤相比，肢端黑色素瘤的总体生存率更差。Breslow 厚度对非肢端黑色素瘤的预后价值更显著。
本研究为回顾性、单中心设计。
与非肢端黑色素瘤相比，肢端黑色素瘤具有更长的放射状生长阶段。然而，肢端黑色素瘤常伴有淋巴结转移，这导致其生存率低于非肢端黑色素瘤。
