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Multicenter Study
. 2021 Jan-Dec:28:10732748211053567.
doi: 10.1177/10732748211053567.

Acral Lentiginous Melanoma: A United States Multi-Center Substage Survival Analysis

Avani M Kolla  1 , Gerardo A Vitiello  2 , Erica B Friedman  2 , James Sun  3 , Aishwarya Potdar  3   4 , Hala Daou  3   4 , Norma E Farrow  5 , Clara R Farley  6 , John T Vetto  7 , Dale Han  7 , Marvi Tariq  6 , Georgia M Beasley  5 , Carlo M Contreras  8 , Michael Lowe  6 , Jonathan S Zager  3   4 , Iman Osman  1 , Russell S Berman  2 , Tracey N Liebman  1 , Jennifer A Stein  1 , Ann Y Lee  2
Affiliations
Multicenter Study

Acral Lentiginous Melanoma: A United States Multi-Center Substage Survival Analysis

Avani M Kolla et al. Cancer Control. 2021 Jan-Dec.

Abstract

Background: 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.

Objectives: 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.

Methods: 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.

Results: 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; P < .001)) and positive nodal status ((HR) = 1.79; 95% CI = 1.00-3.22; P = .050)) were independent prognostic factors for melanoma-specific survival. Breslow depth ((HR = 1.13; 95% CI = 1.07-1.20; P < .001), and positive nodal status (HR = 2.12; 95% CI = 1.38-3.80; P = .001) were also prognostic factors for recurrence-free survival.

Conclusion: 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.

Keywords: acral lentiginous melanoma; melanoma; outcomes; skin cancer; substage.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Kaplan–meier curves for 5-year melanoma-specific survival stratified by pathologic AJCC eighth edition stage (A) and substage (B) and for 5-year recurrence-free survival stratified by stage (C) and substage (D).
See this image and copyright information in PMC

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