Acral lentiginous melanoma versus other melanoma: A single-center analysis in Japan
Acral lentiginous melanoma versus other melanoma: A single-center analysis in Japan
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DOI：
10.1111/1346-8138.13834
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发表时间：
2017-08-01
影响因子：
3.1
通讯作者：
Uchi, Hiroshi
中科院分区：
文献类型：
--
作者：
Wada, Maiko;Ito, Takamichi;Uchi, Hiroshi
我们在此总结了我们在分子靶向治疗和免疫治疗时代之前的14年常规治疗结果的经验。具体而言，我们对252例原发性皮肤黑色素瘤患者（肢端雀斑样痣黑色素瘤[ALM]，n = 121;非肢端雀斑样痣黑色素瘤[非ALM]，n = 131）进行了回顾性分析，并比较了ALM和非ALM之间的预后因素。使用Kaplan-Meier方法估计黑色素瘤特异性生存期和无病生存期。关于结果，所有患者均为日本人（106例男性和146例女性），平均年龄为60.1岁。在ALM患者中，年龄较大，原发肿瘤的大小大于非ALM。至于肿瘤厚度，原位病变在ALM中更常见。排除原位病灶后，两组肿瘤厚度分布无显著差异。对于原发性黑色素瘤的治疗，248例患者（98.4%）接受了根治性手术切除，120例超过1 mm或溃疡性黑色素瘤患者接受了前哨淋巴结活检。全身转移的患者主要接受以达卡巴嗪为基础的化疗。Kaplan-Meier生存曲线显示，ALM和非ALM患者的黑色素瘤特异性生存率和无病生存率无显著差异。结果还表明，ALM和非ALM，当它们最初转移时，首先影响区域淋巴结。切口活检不是不良预后因素。这些结果表明，ALM在其生物学行为上与非ALM没有区别，因此我们可以认为ALM等同于非ALM。ALM和非ALM的初始治疗可以涉及相同的策略。
We summarize herein our 14-year experience of conventional treatment outcomes before the era of molecular-targeted therapy and immunotherapy. Specifically, we conducted a retrospective review of our 252 patients with primary cutaneous melanoma (acral lentiginous melanoma [ALM], n = 121; non-acral lentiginous melanoma [non-ALM], n = 131), and compared the prognostic factors between ALM and non-ALM. Melanoma-specific survival and disease-free survival were estimated using the Kaplan-Meier method. Regarding the results, all patients were Japanese (106 male and 146 female), with a mean age of 60.1 years. Among ALM patients, age was elder and primary tumor size was larger than non-ALM. As for tumor thickness, in situ lesions were more frequently observed in ALM. There was no significant difference in the distribution of tumor thickness between the two groups when excluding the in situ lesions. For treatment of the primary melanoma, 248 patients (98.4%) had undergone curative surgical excision and 120 patients with more than 1 mm or ulcerated melanoma had undergone sentinel lymph node biopsy. Patients with systemic metastasis primarily underwent dacarbazine-based chemotherapy. The Kaplan-Meier survival curves revealed no significant difference in melanoma-specific survival and disease-free survival between those with ALM and non-ALM. The results also showed that both ALM and non-ALM, when they initially metastasize, first affect the regional lymph nodes. Incisional biopsy was not an adverse prognostic factor. These results suggest that ALM does not differ in its biological behavior from non-ALM, so we can consider ALM as being equivalent to non-ALM. The initial treatment for ALM and non-ALM can involve the same strategy.