Zheng Xuejing, Wu Wence, Yu Shengji
Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Am Surg. 2024 Apr;90(4):600-606. doi: 10.1177/00031348231204915. Epub 2023 Sep 26.
The objective of this study is to investigate the epidemiological features, clinical characteristics, and pathological characteristics of acral lentiginous melanoma (ALM) and identify prognostic factors.
A total of 149 patients diagnosed with ALM between August 2008 and December 2019 at the National Cancer Center (NCC) of China were retrospectively analyzed. Follow-up data on patient survival status were collected. Survival curves were generated using the Kaplan-Meier method, and statistical significance was assessed using the log-rank test. Additionally, a Cox proportional hazards model was constructed to identify prognostic factors.
All patients included in this study were of Chinese ethnicity, with an average age of 52.4 ± 14.8 years (range, 15-80 years) at the time of diagnosis. No gender predilection or genetic susceptibility was observed. The plantar region was the most frequently affected site among primary lesions. Notably, only 17 (11.4%) patients reported a history of trauma. Statistical analysis revealed that a lesion duration of ≤2.5 years, Breslow thickness >4.0 mm, high mitotic rate (>6 mm-2), presence of vascular invasion, and regional lymph node metastasis were identified as independent prognostic factors.
Our findings indicate that a lesion duration of ≤2.5 years, Breslow thickness >4.0 mm, high mitotic rate (>6 mm), presence of vascular invasion, and regional lymph node metastasis are significantly associated with a poorer prognosis for patients with ALM.
本研究旨在探讨肢端雀斑样痣黑色素瘤（ALM）的流行病学特征、临床特征和病理特征，并确定预后因素。
回顾性分析2008年8月至2019年12月在中国国家癌症中心（NCC）诊断为ALM的149例患者。收集患者生存状态的随访数据。采用Kaplan-Meier法生成生存曲线，并使用对数秩检验评估统计学意义。此外，构建Cox比例风险模型以确定预后因素。
本研究纳入的所有患者均为中国汉族，诊断时的平均年龄为52.4±14.8岁（范围15-80岁）。未观察到性别偏好或遗传易感性。足底区域是原发性病变中最常受累的部位。值得注意的是，只有17例（11.4%）患者报告有创伤史。统计分析显示，病变持续时间≤2.5年、Breslow厚度>4.0mm、高有丝分裂率（>6个/mm²）、存在血管侵犯和区域淋巴结转移被确定为独立的预后因素。
我们的研究结果表明，病变持续时间≤2.5年、Breslow厚度>4.0mm、高有丝分裂率（>6个/mm²）、存在血管侵犯和区域淋巴结转移与ALM患者较差的预后显著相关。
