Prognostic significance of acral lentiginous histologic type in T1 melanoma.
Adolescent
Adult
Aged
Aged, 80 and over
Cell Proliferation
Child
Child, Preschool
Clinical Decision-Making
Disease Progression
Disease-Free Survival
Female
Humans
Infant
Lymphatic Metastasis
Male
Melanocytes
/ pathology
Melanoma
/ mortality
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Risk Factors
Sentinel Lymph Node Biopsy
Skin Neoplasms
/ mortality
Time Factors
Young Adult
Journal
Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
ISSN: 1530-0285
Titre abrégé: Mod Pathol
Pays: United States
ID NLM: 8806605
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
19
05
2020
accepted:
20
07
2020
revised:
20
07
2020
pubmed:
8
8
2020
medline:
4
11
2021
entrez:
8
8
2020
Statut:
ppublish
Résumé
Acral lentiginous melanoma (ALM) is a rare type of cutaneous melanoma with a poor prognosis. It is unclear whether the poor outcome of ALM is due to its inherent disease characteristics or advanced stage at initial diagnosis. To address this question, we retrospectively analyzed the clinicopathologic factors of 828 thin (T1; Breslow thickness ≤1.0 mm) melanomas [129 (15.6%) ALMs and 699 (84.4%) non-ALMs] and their nodal and distance metastases and local recurrence rates and determined their relationship with the disease-specific (DSS), overall (OS), and recurrence-free survivals (RFS) at the pathologic stages T1, T1a, and T1b with a median follow-up time of 84.5 months. With the exception of OS at T1b stage, ALM patients showed significantly lower 5- and 10-year DSS, OS, and RFS rates at every pathologic stage when compared with non-ALM. In multivariable analysis, ALM histologic type, SLN positivity, age, and the use of systemic therapy were detected as independent poor prognostic factors associated with significantly lower survival rates. ALM histologic type was associated with lower DSS and OS rates at T1 and T1a stages and lower RFS rates at T1b stage. SLN positivity was associated with lower DSS, OS, and RFS rates at T1, T1a, and T1b stages. Age was associated with lower OS rates at T1 and T1b stages. Whereas the use of systemic therapy was associated with lower DSS rates at T1a stage and RFS rates at T1b stage. In addition, the ALM group showed significantly older median age patients and higher rates of female sex, Hispanic ethnicity, nevoid cytology, non-brisk tumor-infiltrating lymphocytes, nodal metastasis, and local recurrence at every pathologic stage of thin melanoma. Our findings suggest that ALM is inherently more aggressive than other types of cutaneous melanoma. This information may be useful for prognostic stratification of patients with thin melanomas, especially to help guide the clinical decision-making for SLN biopsy and patients entering clinical trials.
Identifiants
pubmed: 32759976
doi: 10.1038/s41379-020-0641-x
pii: S0893-3952(22)00657-3
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
572-583Subventions
Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
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