The Ronald O. Perelman Department of Dermatology, 12297NYU Langone Health, New York, NY, USA.
Department of Surgery, 12297NYU Langone Health, New York, NY, USA.
Cancer Control. 2021 Jan-Dec;28:10732748211053567. doi: 10.1177/10732748211053567.
Acral lentiginous melanoma is associated with worse survival than other subtypes of melanoma. Understanding prognostic factors for survival and recurrence can help better inform follow-up care.
To analyze the clinicopathologic features, melanoma-specific survival, and recurrence-free survival by substage in a large, multi-institutional cohort of primary acral lentiginous melanoma patients.
Retrospective review of the United States Melanoma Consortium database, a multi-center prospectively collected database of acral lentiginous melanoma patients treated between January 2000 and December 2017.
Of the 433 primary acral lentiginous melanoma patients identified (median [range] age: 66 [8-97] years; 53% female, 83% white), 66% presented with stage 0-2 disease and the median time of follow-up for the 392 patients included in the survival analysis was 32.5 months (range: 0-259). The 5-year melanoma-specific survivals by stage were 0 = 100%, I = 93.8%, II = 76.2%, III = 63.4%, IIIA = 80.8%, and IV = 0%. Thicker Breslow depth ((HR) = 1.13; 95% CI = 1.05-1.21; < .001)) and positive nodal status ((HR) = 1.79; 95% CI = 1.00-3.22; = .050)) were independent prognostic factors for melanoma-specific survival. Breslow depth ((HR = 1.13; 95% CI = 1.07-1.20; < .001), and positive nodal status (HR = 2.12; 95% CI = 1.38-3.80; = .001) were also prognostic factors for recurrence-free survival.
In this cohort of patients, acral lentiginous melanoma was associated with poor outcomes even in early stage disease, consistent with prior reports. Stage IIB and IIC disease were associated with particularly low melanoma-specific and recurrence-free survival. This suggests that studies investigating adjuvant therapies in stage II patients may be especially valuable in acral lentiginous melanoma patients.
肢端雀斑样黑色素瘤的生存预后较其他黑色素瘤亚型差。了解生存和复发的预后因素有助于更好地指导随访护理。
分析大样本多中心肢端雀斑样黑色素瘤患者的临床病理特征、黑色素瘤特异性生存和无复发生存，按亚分期进行分析。
回顾性分析美国黑色素瘤联盟数据库，这是一个多中心前瞻性收集的肢端雀斑样黑色素瘤患者数据库，患者于 2000 年 1 月至 2017 年 12 月接受治疗。
在 433 例原发性肢端雀斑样黑色素瘤患者中（中位[范围]年龄：66 [8-97]岁；53%为女性，83%为白人），66%患者分期为 0-2 期，纳入生存分析的 392 例患者的中位随访时间为 32.5 个月（范围：0-259）。按分期，5 年黑色素瘤特异性生存率为 0=100%，I=93.8%，II=76.2%，III=63.4%，IIIA=80.8%，IV=0%。Breslow 厚度较厚（HR=1.13；95%CI=1.05-1.21；<.001）和阳性淋巴结状态（HR=1.79；95%CI=1.00-3.22；=0.050）是黑色素瘤特异性生存的独立预后因素。Breslow 厚度（HR=1.13；95%CI=1.07-1.20；<.001）和阳性淋巴结状态（HR=2.12；95%CI=1.38-3.80；=0.001）也是无复发生存的预后因素。
在本队列患者中，肢端雀斑样黑色素瘤即使在早期疾病中也与不良结局相关，这与既往报道一致。IIB 期和 IIC 期疾病与黑色素瘤特异性和无复发生存率特别低相关。这表明，在肢端雀斑样黑色素瘤患者中，研究辅助治疗 II 期患者可能特别有价值。
