Acral lentiginous melanoma - a skin cancer with unfavourable prognostic features. A study of the German Central Malignant Melanoma Registry (CMMR) in 2050 patients

Abstract

Background

Acral lentiginous melanoma (ALM) is one of the four major subtypes in cutaneous melanoma (CM). Although ALM has a poorer prognosis than other CM subtypes, the prognostic factors of ALM have been verified only in small-sized cohorts because of the low incidence of ALM worldwide.

Objectives

To investigate clinical characteristics of ALM and to evaluate their prognostic values based on a large dataset from the Central Malignant Melanoma Registry (CMMR) of the German Dermatologic Society.

Methods

The Kaplan-Meier method was used to estimate the potential influence of clinical and histological parameters on ALM disease-specific survival (DSS) curves, which were compared using log-rank test. A cox proportional hazards model was used to identify independent prognostic factors for DSS.

Results

2,050 ALM patients were identified from 58,949 CM patients recorded by CMMR with follow-up data. In multivariate analyses, age (p=0.006), ulceration (p = 0.013), tumour thickness (p < 0.001) and tumour spread (p < 0.001) turned out to be significant prognostic factors for DSS in ALM whereas gender, nevus association and level of invasion were not independent factors.

Conclusion

Acral lentiginous melanoma has the same prognostic factors as the other subtypes of melanoma. Unfavourable prognosis probably derives from the delay of diagnosis in comparison to other melanoma subtypes.

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