January 1995

Acral Lentiginous Melanoma

Author Affiliations

From the Department of Surgical Oncology, University of Illinois at Chicago.

Arch Surg. 1995;130(1):88-92. doi:10.1001/archsurg.1995.01430010090019

Objective:  To analyze whether the histologic subtype acral lentiginous melanoma confers independent prognostic significance.

Design:  Case series retrospective review.

Setting:  Academic surgical practice.

Patients or Other Participants:  Fifty-six patients with histologically confirmed acral lentiginous melanoma identified from patients with malignant melanoma consecutively treated by the faculty of the Department of Surgical Oncology at the University of Illinois at Chicago.

Interventions:  Not applicable.

Main Outcome Measures:  Lymph node metastases, disease-free survival, and overall concurrent or subsequent survival.

Results:  The average age of our patients with acral lentiginous melanoma was 61.1 years. Thirty-four (61%) were white, and the remaining 22(39%) were African-American, Hispanic, or Asian. Thirty (54%) were male and 26 (46%) were female. The primary tumor occurred on the lower extremity in 46 (82%) of the cases and on the upper extremity in the remaining 10(18%). Twenty-four primary tumors (43%) were greater than 4.00mm thick. Analyzed by means of a logistic regression model, the rate of lymph node metastases did not significantly differ among patients with acral lentiginous melanoma, superficial spreading melanoma, and nodular malignant melanoma. Furthermore, when corrected for tumor thickness, disease-free and overall survival were the same for the three histologic groups. Multifactorial analysis identified only thickness as a prognostic variable for disease-free survival and overall survival.

Conclusions:  Despite the greater age, diverse ethnic background, and distinctive tumor characteristics of our patients with acral lentiginous melanoma, this histologic subtype does not, in itself, affect the outcome of these patients.(Arch Surg. 1995;130:88-92)