Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features
Background: Acral melanoma is associated with poor prognosis. Studying the characteristics and prognosis of Caucasian patients is crucial to understand the distinct features of this tumor. Objectives: To analyze the epidemiological, clinicopathological, and prognostic features of acral melanoma in C...
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| Format: | Article |
| Status: | Published version |
| Publication date: | 2025 |
| Country: | España |
| Institution: | Universitat de Lleida (UdL) |
| Repository: | Repositori Obert UdL |
| OAI Identifier: | oai:repositori.udl.cat:10459.1/467574 |
| Online Access: | https://doi.org/10.1016/j.ad.2024.10.060 https://hdl.handle.net/10459.1/467574 |
| Access Level: | Open access |
| Keyword: | Acral melanoma Cutaneous melanoma Foot melanoma Hand melanoma Prognostic factor Risk factor Survival analysis Melanoma acral Factor de riesgo Factor pronóstico Melanoma cutáneo Análisis de supervivencia Melanoma de pie Melanoma de mano |
| _version_ | 1878741377478557696 |
|---|---|
| author | Àngel Baldó, Joan |
| author2 | Podlipnik, Sebastian Azon, Antoni Boada, Aram Arrieta Gisasola, Ainhoa Marcoval, Joaquim López Sánchez, Cristina Sabat, Mireia Segura, Sonia Bodet, Domingo Curcó, Neus López Castillo, Daniel Sola, Joaquim Quintana, Mònica Baliu-Piqué, Carola Just Sarobé, Miquel Martín-Sala, Sara Malvehy, Josep Puig, Susana Carrera, Cristina Martí Laborda, Rosa Ma. |
| author2_role | author author author author author author author author author author author author author author author author author author author author |
| author_browse | Arrieta Gisasola, Ainhoa Azon, Antoni Baliu-Piqué, Carola Boada, Aram Bodet, Domingo Carrera, Cristina Curcó, Neus Just Sarobé, Miquel López Sánchez, Cristina López Castillo, Daniel Malvehy, Josep Marcoval, Joaquim Martí Laborda, Rosa Ma. Martín-Sala, Sara Podlipnik, Sebastian Puig, Susana Quintana, Mònica Sabat, Mireia Segura, Sonia Sola, Joaquim Àngel Baldó, Joan |
| author_facet | Àngel Baldó, Joan Podlipnik, Sebastian Azon, Antoni Boada, Aram Arrieta Gisasola, Ainhoa Marcoval, Joaquim López Sánchez, Cristina Sabat, Mireia Segura, Sonia Bodet, Domingo Curcó, Neus López Castillo, Daniel Sola, Joaquim Quintana, Mònica Baliu-Piqué, Carola Just Sarobé, Miquel Martín-Sala, Sara Malvehy, Josep Puig, Susana Carrera, Cristina Martí Laborda, Rosa Ma. |
| author_role | author |
| collection | Repositori Obert UdL |
| description | Background: Acral melanoma is associated with poor prognosis. Studying the characteristics and prognosis of Caucasian patients is crucial to understand the distinct features of this tumor. Objectives: To analyze the epidemiological, clinicopathological, and prognostic features of acral melanoma in Caucasian patients. Methods: We conducted a retrospective, multicenter, cohort study of acral melanoma from a database across 20 hospitals from South Europe from January 2000 to December 2019. Results: A total of 733 acral melanomas were identified (median age, 67.5 years; 95.2%, Caucasians; 77.5% of which were located on the feet). Overall, 77.5% of cases were invasive melanomas. Foot melanomas had a higher proportion of invasive cases (80.8% vs 69.8%; p = 0.003), stages III and IV at diagnosis (24.8% vs 11.7%; p < 0.001), thicker Breslow depth (2.8 mm vs 2.0 mm; p = 0.021) and a higher rate of positive sentinel lymph node biopsy (SLNB) (30.7% vs 15.7%; p = 0.012). Thicker Breslow depth and later age of onset were risk factors for melanoma-specific survival. Thicker Breslow depth and ulceration were independent prognostic factors of relapse-free survival. Melanoma location and histopathological subtype were not associated with worse prognosis. Recurrences were a common finding (27.7%), with distant metastases appearing earlier than locoregional recurrences (1.32 years [IQR, 1.12---1.87] vs 2.14 years [IQR, 1.68---2.70]; p = 0.015). Conclusion: This study, the largest in a predominantly Caucasian population, underscores the unfavorable outcomes of acral melanoma. Foot melanomas exhibited delayed detection, increased invasiveness, thicker Breslow depth, increased SLNB involvement, and higher AJCC stages. The high recurrence rate and early distant metastases emphasize the critical role of intensive follow-up and routine imaging modalities to detect asymptomatic relapses. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_e42276cbbea2ee7db9caee8d3a55dc0c |
| institution | Universitat de Lleida (UdL) |
| instname_str | Universitat de Lleida (UdL) |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:repositori.udl.cat:10459.1/467574 |
| publishDate | 2025 |
| publishDateSort | 2025 |
| publisher | Elsevier |
| publisherStr | Elsevier |
| reponame_str | Repositori Obert UdL |
| spelling | Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features Melanoma acral en población caucásica: estudio de cohorte sobre factores epidemiológicos, clinicopatológicos y pronósticos Àngel Baldó, Joan Podlipnik, Sebastian Azon, Antoni Boada, Aram Arrieta Gisasola, Ainhoa Marcoval, Joaquim López Sánchez, Cristina Sabat, Mireia Segura, Sonia Bodet, Domingo Curcó, Neus López Castillo, Daniel Sola, Joaquim Quintana, Mònica Baliu-Piqué, Carola Just Sarobé, Miquel Martín-Sala, Sara Malvehy, Josep Puig, Susana Carrera, Cristina Martí Laborda, Rosa Ma. Acral melanoma Cutaneous melanoma Foot melanoma Hand melanoma Prognostic factor Risk factor Survival analysis Melanoma acral Factor de riesgo Factor pronóstico Melanoma cutáneo Análisis de supervivencia Melanoma de pie Melanoma de mano Background: Acral melanoma is associated with poor prognosis. Studying the characteristics and prognosis of Caucasian patients is crucial to understand the distinct features of this tumor. Objectives: To analyze the epidemiological, clinicopathological, and prognostic features of acral melanoma in Caucasian patients. Methods: We conducted a retrospective, multicenter, cohort study of acral melanoma from a database across 20 hospitals from South Europe from January 2000 to December 2019. Results: A total of 733 acral melanomas were identified (median age, 67.5 years; 95.2%, Caucasians; 77.5% of which were located on the feet). Overall, 77.5% of cases were invasive melanomas. Foot melanomas had a higher proportion of invasive cases (80.8% vs 69.8%; p = 0.003), stages III and IV at diagnosis (24.8% vs 11.7%; p < 0.001), thicker Breslow depth (2.8 mm vs 2.0 mm; p = 0.021) and a higher rate of positive sentinel lymph node biopsy (SLNB) (30.7% vs 15.7%; p = 0.012). Thicker Breslow depth and later age of onset were risk factors for melanoma-specific survival. Thicker Breslow depth and ulceration were independent prognostic factors of relapse-free survival. Melanoma location and histopathological subtype were not associated with worse prognosis. Recurrences were a common finding (27.7%), with distant metastases appearing earlier than locoregional recurrences (1.32 years [IQR, 1.12---1.87] vs 2.14 years [IQR, 1.68---2.70]; p = 0.015). Conclusion: This study, the largest in a predominantly Caucasian population, underscores the unfavorable outcomes of acral melanoma. Foot melanomas exhibited delayed detection, increased invasiveness, thicker Breslow depth, increased SLNB involvement, and higher AJCC stages. The high recurrence rate and early distant metastases emphasize the critical role of intensive follow-up and routine imaging modalities to detect asymptomatic relapses. Introducción: El melanoma acral está asociado con un pronóstico desfavorable. El estudio sobre las características y el pronóstico en los pacientes caucásicos puede ser crucial para comprender las características distintivas de este tumor. Objetivos: Analizar las características epidemiológicas, clinicopatológicas y pronósticas del melanoma acral en los pacientes caucásicos. Material y métodos: Estudio de cohorte retrospectivo de melanoma acral a partir de una base de datos multi-institucional en 20 hospitales españoles, entre enero de 2000 y diciembre de 2019. Resultados: Se identificaron un total de 733 melanomas acrales (edad media: 67,5 años, el 95,2% caucásicos y el 77,5% en los pies). En general, el 77,5% de los casos fueron invasivos. Los melanomas localizades en los pies tuvieron una mayor proporción de casos invasivos (80,8 vs. 69,8%; p = 0,003), estadios III y IV al diagnóstico (24,8 vs. 11,7%; p < 0,001), valores de Breslow más altos (2,8 vs. 2,0 mm; p = 0,021) y una mayor tasa de positividad de biopsia selectiva del ganglio centinela (BSGC) (30,7 vs. 15,7%; p = 0,012). Un mayor grosor de Breslow y una edad de aparición más tardía fueron factores de riesgo para la supervivencia específica del melanoma. Un mayor grosor de Breslow y la ulceración fueron los factores pronósticos independientes para la supervivencia libre de recaída. La localización del melanoma y el subtipo histopatológico no se asociaron con un peor pronóstico. Las recurrencias fueron frecuentes (27,7%), con metástasis distantes apareciendo antes que las recurrencias locorregionales (1,32 a˜nos [IQR: 1,12-1,87] vs. 2,14 añnos [IQR: 1,68-2,70]; p = 0,015). Conclusión: Este estudio, el mayor en una población predominantemente caucásica, subraya los resultados desfavorables del melanoma acral. Los melanomas en los pies mostraron una detección tardía, mayor proporción de melanomas invasivos, valores de Breslow más profundos, mayor positividad o afectación de BSGC y estadios AJCC más altos. La alta tasa de recurrencia y las metástasis distantes tempranas enfatizan el papel crítico del seguimiento intensivo y las pruebas de imagen rutinarias para detectar recaídas asintomáticas. Elsevier https://doi.org/10.1016/j.ad.2024.10.060 https://hdl.handle.net/10459.1/467574 |
| spellingShingle | Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features Àngel Baldó, Joan Acral melanoma Cutaneous melanoma Foot melanoma Hand melanoma Prognostic factor Risk factor Survival analysis Melanoma acral Factor de riesgo Factor pronóstico Melanoma cutáneo Análisis de supervivencia Melanoma de pie Melanoma de mano |
| status_str | publishedVersion |
| title | Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features |
| title_full | Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features |
| title_fullStr | Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features |
| title_full_unstemmed | Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features |
| title_short | Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features |
| title_sort | Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features |
| topic | Acral melanoma Cutaneous melanoma Foot melanoma Hand melanoma Prognostic factor Risk factor Survival analysis Melanoma acral Factor de riesgo Factor pronóstico Melanoma cutáneo Análisis de supervivencia Melanoma de pie Melanoma de mano |
| topic_facet | Acral melanoma Cutaneous melanoma Foot melanoma Hand melanoma Prognostic factor Risk factor Survival analysis Melanoma acral Factor de riesgo Factor pronóstico Melanoma cutáneo Análisis de supervivencia Melanoma de pie Melanoma de mano |
| url | https://doi.org/10.1016/j.ad.2024.10.060 https://hdl.handle.net/10459.1/467574 |