Management of Primary Cutaneous Melanoma of the Hands and Feet: A Clinicoprognostic Study
Management of Primary Cutaneous Melanoma of the Hands and Feet: A Clinicoprognostic Study
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DOI：
10.1111/j.1524-4725.2009.01265.x
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发表时间：
2009-10-01
影响因子：
2.4
通讯作者：
Ferrandiz, Carlos
中科院分区：
文献类型：
--
作者：
Rex, Jordi;Paradelo, Cristina;Ferrandiz, Carlos
肢端雀斑样黑色素瘤（acral lentiginous melanoma，AM）是肢端最常见的恶性黑色素瘤亚型，但AM的临床和病理特征与其他部位的黑色素瘤不同患者和方法在20年的时间里，在数据库中记录了822例连续的黑色素瘤患者。我们从黑色素瘤登记处检索临床和随访数据并进行前瞻性分析。发现Breslow厚度和Clark水平与特异性和无病生存相关。Breslow厚度大于4 mm与复发风险增加相关，无色素症和年龄大于60岁与死亡风险增加显著相关。AM患者的生存率与NAM患者的生存率比较清楚地表明，无病生存率和总生存率显着降低，在former.CONCLUSIONSurvival患者之间的差异AM和NAM是由于差异，在已知的预后因素，可能作为一个后果，在这些location.The作者表示没有显着的兴趣与商业支持者。
BACKGROUNDAlthough acral lentiginous melanoma is the most common subtype of malignant melanoma in acral locations, the term acral melanoma (AM) has to be differentiated from the histopathologic description.OBJECTIVESTo characterize the clinical and pathologic features of patients with a primary AM and to elucidate whether the prognosis of patients with AM differs from that of those with melanoma at other sites (nonacral melanoma; NAM).PATIENTS AND METHODOver a 20-year period, a series of 822 consecutive patients with melanoma were recorded in the database. Clinical and follow-up data were retrieved from the melanoma register and prospectively analyzed.RESULTSEighty-nine patients had a malignant melanoma located on the acral sites of extremities. Breslow thickness and Clark level were found to be related to specific and disease-free survival. Breslow thickness greater than 4 mm was associated with greater risk of recurrence, and amelanosis and age of 60 and older were significantly associated with greater risk of death. Comparison of survival of patients with AM with that of those with NAM clearly showed that disease-free survival and overall survival were significantly lower in the former.CONCLUSIONSurvival differences between patients with AM and NAM are due to differences in already known prognostic factors, probably as a consequence of a delay in the diagnosis in these locations.The authors have indicated no significant interest with commercial supporters.