Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
City of Hope National Medical Center, Department of Surgery, Duarte, CA 91010, USA.
Med Sci (Basel). 2021 Sep 15;9(3):57. doi: 10.3390/medsci9030057.
Despite the changing paradigms of melanoma treatment in recent years, there remains a relative paucity of data regarding subungual melanoma in the literature. From 2002-2018, 25 patients with subungual melanoma were surgically treated at our facility. A retrospective chart review was conducted to collect relevant demographic, clinical, pathologic, and outcomes data. The median age at diagnosis was 69 years. Most patients (60%) were male, and the melanoma lesion was most often located on the foot (68%). Acral-lentiginous was the most common histologic subtype (59%), and the median Breslow thickness was 3.4 mm. Fifteen patients (63%) underwent a sentinel lymph node biopsy as part of their surgical resection, and four of these patients (27%) had metastatic disease in the lymph nodes. In total, 10 patients underwent lymph node dissection of the involved basin. The median follow up was 21 months in this patient population. Age, gender, tumor location, ulceration, and lesion histology were not significantly associated with recurrence free survival (RFS). Increasing Breslow thickness was found to be significantly associated with shorter RFS (HR: 1.07, CI: 1.03-1.55). In total, 13 patients developed a disease recurrence, and RFS rates were 66% at 1 year and 40% at 3 years. Additionally, 91 and 37% of patients were alive at one year and three years, respectively. Subungual melanomas are rare lesions that often have a more advanced stage at diagnosis, which contributes to the poor prognosis of these cutaneous malignancies.
尽管近年来黑色素瘤治疗的模式发生了变化，但文献中关于甲下黑色素瘤的数据仍然相对较少。2002 年至 2018 年，我们机构对 25 例甲下黑色素瘤患者进行了手术治疗。进行了回顾性图表审查以收集相关的人口统计学、临床、病理和结果数据。诊断时的中位年龄为 69 岁。大多数患者（60％）为男性，黑色素瘤病变最常位于足部（68％）。肢端雀斑样黑色素瘤是最常见的组织学亚型（59％），中位 Breslow 厚度为 3.4mm。15 例患者（63％）作为手术切除的一部分接受了前哨淋巴结活检，其中 4 例患者（27％）淋巴结有转移性疾病。总共 10 例患者对受累淋巴结区域进行了淋巴结清扫。该患者人群的中位随访时间为 21 个月。年龄、性别、肿瘤位置、溃疡和病变组织学与无复发生存（RFS）无显著相关性。Breslow 厚度增加与较短的 RFS 显著相关（HR：1.07，CI：1.03-1.55）。总共有 13 例患者出现疾病复发，1 年 RFS 率为 66％，3 年 RFS 率为 40％。此外，分别有 91％和 37％的患者在 1 年和 3 年内存活。甲下黑色素瘤是罕见的病变，通常在诊断时处于更晚期，这导致这些皮肤恶性肿瘤的预后较差。
