Effect of anatomical site on prognosis and progression pattern in early-stage acral melanoma: A retrospective cohort study of 281 cases - 19/01/26
Abstract |
Background |
The evolution of human bipedalism has led to distinct functional roles for the lower and upper limbs. In acral lentiginous melanoma (ALM), the factors influencing the first site of metastasis (whether lymphatic or systemic) remain unclear.
Objective |
This study aimed to compare the prognosis and metastatic progression patterns of upper versus lower-limb ALM.
Methods |
Patients with early-stage ALM whose exact location of the tumor was documented were retrospectively analyzed.
Results |
First lymph node metastasis was significantly more frequent in lower-limb ALM, while first distant metastasis was more common in upper-limb ALM. This pattern was more evident in stage II ALM and nail unit melanomas compared to non-nail unit acral melanomas. Cox proportional hazards regression identified upper-limb location, ulceration, Breslow thickness, and lymphovascular invasion as independent predictors of systemic metastasis-free survival. For lymph node progression-free survival, only Breslow thickness and bone involvement were identified as independent prognostic factors.
Limitations |
This was a retrospective study performed at a tertiary referral center.
Conclusion |
Lower-limb ALM, especially toenail melanoma was associated with first lymph node metastasis, while upper-limb ALM was significantly related to first distant metastasis, implying necessity of tailored surveillance strategies in early-stage ALM.
Le texte complet de cet article est disponible en PDF.Key words : Acral lentiginous melanoma, Anatomical site, Prognosis, Early-stage melanoma, Lymph node metastasis, Metastatic pattern, Nail unit melanoma, Progression pattern, Systemic metastasis
Abbreviations used : AJCC, ALM, CI, CT, HR, IRB, NNAM, NUM, OS, PFS
Plan
| Funding sources: None. |
|
| Patient consent: Not applicable. |
|
| IRB approval status: Reviewed and approved by the Institutional Review Board (IRB) of Asan Medical Center; Approval No. 2021-0648. |
|
| Data statement: The data from this study have not been previously published. |
Vol 94 - N° 2
P. 467-477 - février 2026 Retour au numéro
Article précédent
- Comparative risk of reactivation of hepatitis B and C after treatment with biologics and targeted synthetic DMARDs in psoriasis and psoriatic arthritis: A 15-year multicenter cohort study
- Hsien-Yi Chiu, Che-Chia Hsu, Tsen-Fang Tsai, Kuo-Lung Lai, Sung-Jen Hung, Nan-Lin Wu, Kai Che Wei, Tsu-Man Chiu, Shao-Hsuan Hsu, Ting-Yuan Lan, Chaw-Ning Lee, Ying- Ming Chiu, Rosaline Chung-yee Hui, Ching-Chi Chi, Chun-Bing Chen, Chao-Chun Yang, I-Lun Tseng, Yu-Huei Huang
- JAAD Game Changer: Adalimumab in conjunction with surgery compared with adalimumab monotherapy for hidradenitis suppurativa: A randomized controlled trial in a real-world setting
- Craig Fisher, Wendi E. Wohltmann
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?