Abstract
Background Acral melanoma (AM) is a rare subtype of melanoma, which is one of the least common in Caucasian patients but is a common subtype of melanoma in Chinese patients. It is unclear if prognosis differs between Chinese and Caucasian patients diagnosed with AM. The aim of our study is to investigate patient characteristics and survival differences between Chinese and Caucasian AM patients. Methods Two large institutional melanoma databases from Fudan University Shanghai Cancer Center (FUSCC) and Mayo Clinic enterprise were retrospectively reviewed from 2009 to 2015. Clinicopathologic and survival data were collected and analyzed between the two groups. The primary outcome was disease-specific survival (DSS) and was calculated using the Kaplan Meier (KM) method. Results The Chinese group presented with more advanced disease compared with Caucasians: thicker Breslow depth (median 3.0 mm vs. 1.2 mm, p=0.003), more ulcerated disease (66.1% vs. 29%; p < 0.001), and advanced stages (stage II/III 84.3% vs. 37.1%; p < 0.001). No significant difference was identified in terms of age at diagnosis, location, histologic subtypes, or node positive rate. The 5-year DSS rate was 68.4% and 73% (p=0.56) in Chinese and Caucasians AM patients, respectively. Male gender, Breslow thickness, ulceration, and positive sentinel lymph nodes were independent poor prognostic factors on multivariate analysis. Conclusions There appears to be no difference in stage-stratified survival between Chinese and Caucasians, supporting the implementation of clinical trials for AM that could include both Chinese and Caucasian patients.
Highlights
Malignant melanoma is the most common potentially fatal neoplasm of the skin, and its incidence has increased steadily over the last several decades [1]
Based on the anatomic location of the tumor and the degree of UV exposure, melanoma can be classified into four subtypes: (1) melanomas that occur on the skin without chronic sun-induced damage; (2) melanomas on the skin with chronic sun-induced damage (CSD); (3) mucosal melanomas; and (4) acral melanomas [2]
Acral melanoma (AM) is a distinct subgroup of cutaneous melanoma occurring on the palmoplantar and subungual sites with specific histological and clinicopathological features, regardless of histologic type [10]
Summary
Malignant melanoma is the most common potentially fatal neoplasm of the skin, and its incidence has increased steadily over the last several decades [1]. AM occurs in areas with little to no sun exposure, such as palms, soles, or nail apparatus It is the least common subtype of cutaneous melanoma in Caucasians (1–7%), but it is the most common type of melanoma diagnosed in nonwhite populations (Asians, Hispanics, Black American, etc.), [3,4,5,6] accounting for 58% of all cutaneous melanomas in Asians. Acral melanoma (AM) is a rare subtype of melanoma, which is one of the least common in Caucasian patients but is a common subtype of melanoma in Chinese patients. It is unclear if prognosis differs between Chinese and Caucasian patients diagnosed with AM. Conclusions. ere appears to be no difference in stage-stratified survival between Chinese and Caucasians, supporting the implementation of clinical trials for AM that could include both Chinese and Caucasian patients
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