ACRAL LENTIGINOUS MELANOMA

Objective: To analyze whether the histologic subtype acral lentiginous melanoma confers independent prognostic significance. Design: Case se ries retrospective review. Setting: Academic surgical practice. Patien ts or Other Participants: Fifty-six patients with histologically confi rmed acral lentiginous melanoma identified from patients with malignan t melanoma consecutively treated by the faculty of the Department of S urgical Oncology at the University of Illinois at Chicago. Interventio ns: Not applicable. Main Outcome Measures: Lymph node metastases, dise ase-free survival, and overall concurrent or subsequent survival. Resu lts: The average age of our patients with acral lentiginous melanoma w as 61.1 years. Thirty-four (61%) were white, and the remaining 22 (39% ) were African-American, Hispanic, or Asian. Thirty (54%) were male an d 26 (46%) were female. The primary tumor occurred on the lower extrem ity in 46 (82%) of the cases and on the upper extremity in the remaini ng 10 (18%). Twenty-four primary tumors (43%) were greater than 4.00 m m thick. Analyzed by means of a logistic regression model, the rate of lymph node metastases did not significantly differ among patients wit h acral lentiginous melanoma, superficial spreading melanoma, and nodu lar malignant melanoma. Furthermore, when corrected for tumor thicknes s, disease-free and overall survival were the same for the three histo logic groups. Multifactorial analysis identified only thickness as a p rognostic variable for disease-free survival and overall survival. Con clusions: Despite the greater age, diverse ethnic background, and dist inctive tumor characteristics of our patients with acral lentiginous m elanoma, this histologic subtype does not, in itself, affect the outco me of these patients.