Abstract
This study aimed to investigate the accuracy and safety of fine-needle aspiration cytology (FNAC) in Chinese patients with acral and cutaneous melanoma, and also to evaluate the influencing factors and their impact on prognosis. Data of 128 patients with stage 0–III acral and cutaneous melanoma treated in Fudan University Shanghai Cancer Center from 2009 to 2016 were collected from a prospective database. Further, 128 patients who did not undergo FNAC but had similar parameters were recruited as the matched group. Clinical features, FNAC status, and recurrence or metastasis status of patients were analyzed for overall survival (OS), melanoma-specific survival (MSS), recurrence-free survival (RFS), and metastasis-free survival (MFS). Of the 128 patients with FNAC, 5.5% (7/128) had a negative cytological diagnosis, 12.2% (5/41) had primary lesions, and 2.3% (2/87) had lesions in lymph nodes. Tumor thickness, status of ulceration, and subtype were not associated with accuracy for both primary and lymph node FNAC. With a median follow-up of 40 months in all patients, 55 had melanoma-specific death; the median OS and MSS were 95 months and 104 months, respectively. Patients with FNAC had significantly worse OS. Tumor progression occurred in 130 patients. The survival analysis revealed differences in OS and disease-free survival between the two groups. FNAC impacted patients' RFS and MFS; the difference in survival curves of RFS and MFS was also statistically significant. FNAC on primary or superficial lymphatic lesions was a good diagnostic tool for Chinese patients with acral and cutaneous melanoma, but it adversely impacted prognosis.
Highlights
Malignant melanoma (MM) is a malignant tumor caused by excessive proliferation of abnormal melanocytes [1]
The clinical stage was based on the eighth edition of the American Joint Committee on Cancer (AJCC)
Patients with melanoma have the characteristics of thicker infiltration depth, higher ulcer incidence, and higher lymphatic metastasis rate in China compared with Western countries
Summary
Malignant melanoma (MM) is a malignant tumor caused by excessive proliferation of abnormal melanocytes [1]. In Western countries, patients with cutaneous type as their main type of MM are routinely screened according to the ABCDE rule and undergo an excisional biopsy for small, suspicious lesions [3]. It is very common that patients would not come to visit unless their primary melanoma or regional lymph nodes become symptomatic or very large. Patients with typical melanoma undergoing a wide local resection have similar subsequences as those with an excisional biopsy in terms of resection and onestage repair. Some scholars tried non-invasive or minimally invasive diagnostic methods, including fine-needle aspiration cytology (FNAC) assessment of primary lesions and clinically enlarged lymph nodes, for further treatment. Preoperative ultrasound could not provide reliable lymph node staging in patients with melanoma [4]. The effect of puncture at primary or lymph node sites on patient prognosis has been rarely reported
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
