ACRAL LENTIGINOUS MELANOMA

Between 1958 and 1990, 82 patients with acral lentiginous melanoma wer e treated by the Tulane Surgical Service with regional perfusion, exci sion of lesion, and lymph node dissection. The patient group comprised 27 white men, 29 white women, 18 black men, and 8 black women, with a n average age of 61 years. More foot lesions than hand lesions were re ported, and all the black men had foot lesions. In stage I patients, o verall 5-year survival rates were 65% at 5 years and 44% at 10 years, with differences by race and gender. The black men did poorest, with a 13% 10-year survival rate. Survival rates were worse with increasing disease stage when calculated using univariate analysis. The 5-year su rvival rate of all patients with stage III and stage IV disease was 26 %. A multivariate analysis was performed in 78 of 82 patients in whom all variables of Clark's level, age, race, stage, and sex were known. A strong relationship was observed between decreasing survival time an d increasing Clark's level, with stage of marginal significance. In a multivariate analysis of patients with stage I disease, an increasing level of invasion was found to be significant, with a trend for a rela tionship to thickness. A trend toward decreased survival time was obse rved in men and blacks.