The more dangerous acral melanoma than we thought!

Acral melanoma is recognized as a distinct subgroup of melanoma because of its unique characteristics. For example, in particular epidemiological, clinico-spathological, molecular and prognostic. However, According to the World Health Organization. For example, acral melanomas are those that occur on the glabrous skin of the palmar face of the fingers and toes, palms and the soles of the feet and nail beds. Therefore, Lentiginous acral melanoma is a melanoma histopathological subtype, characterized by specific morphological characteristics. For example, It is clearly associated with a more unfavorable prognosis compared to skin melanoma found in other locations. Therefore, in particular because of these molecular characteristics and its often late diagnosis from more advanced age and non -visible anatomical locations.

Retain – More dangerous acral melanoma than

In the largest study on acral melanoma conducted with a mainly Caucasian population (n = 733). Similarly, researchers have identified a high more dangerous acral melanoma than rate of invasive melanomas (77.5 %) and a significant proportion of cases at stages III and IV at diagnosis. Furthermore,

The results show that remote metastases appear earlier than local recurrences, stressing the importance of intensive monitoring and routine imagery.

Methodology – More dangerous acral melanoma than

• A multicenter retrospective cohort study was carried out in more than 20 hospitals in northeast Spain, analyzing patients with acral melanoma from January 2000 to December 2019, with follow-up until August 2023.
• A total of 733 acral melanomas were identified in 730 patients, with a median age of 67.5 years. Among them, 95.2 % were Caucasians and 77.5 % of the lesions were located on the feet.
• The researchers found that 77.5 % of cases were invasive melanomas, with a higher proportion of invasive cases in feet melanomas (80.8 % against 69.8 %; p = more dangerous acral melanoma than 0.003).

Main results

• Multivariate COX type regression analysis revealed that the late age of appearance (> 75 years) (hazard ratio [HR] 1,61 [1,05-2,46] ; p = 0.030) and a larger breslow thickness (> 1.0-2 mm) (HR 5.85 [1,76-19,45] ; (p = 0.004)) were predictors independent of specific survival with lower melanoma.
• The thickness of Breslow (> 1.0-2 mm) (HR 3.91 [1,62-9,45] ; p = 0.002) and the presence of ulceration (HR 1.57 [1,11-2,22] ; p = 0.011) were independent risk factors for survival without recurrence.
• A total of 202 patients (27.7 %) developed recurrences after an average follow -up of 100 months, with distance metastases appearing earlier than locoregional recurrences (1.32 years against 2.14 years; p = 0.015).
• Remote metastases were mainly pulmonary (34.6 %), followed by liver (13.6 %), central (12.3 more dangerous acral melanoma than %) and remote lymphatic (12.3 %) metastases.

In practice

According to the authors. ” This study, the most important in a mainly Caucasian population, underlines the unfavorable results of acral melanoma. Melanomas of the foot showed late detection. increased invasivity, a greater thickness of Breslow, increased involvement of the Sentinel lymph node, as well as AJCC stages (American Joint Commission on Cancer) higher. The high recidivism rate. early metastases remotely emphasize the crucial role of intensive monitoring and routine imaging methods to detect asymptomatic relapses ».

Main limitations

This is a retrospective study, although the data has been collected in a prospective and multicenter. Missing values have been identified. such as the exact location on acral areas, socio -economic factors, genetic tests of tumors and the margins obtained in surgical procedures related to melanoma. In the case of more dangerous acral melanoma than recurrences. researchers have not explored if patients who initially presented locoregional metastases have developed synchronous metastases or subsequent distance metastases.

Funding. interest links

The search on the melanoma at the University Hospital Arnau of Vilanova de Lleida was supported by the ISCIII/FEDER, CIBERONC-CB16/12/00231 and Government of Catalonia. The Mélanom group of the Clinic Hospital Barcelona received the support of the CIBER of Rares. AGAUR, CERCA Program, a research subsidy of the Scientific Foundation of the Spanish Association Against Cancer, European Commission and Program Horizon Europe. Additional subsidies were received from the Health Research Fund. Some of the work was carried out at the Center Koplowtz, Barcelona. J. Angel-Baldo benefits from a predoctoral scholarship of the IRBLleida/Mail of Lleida.

This article was created using several editorial tools, including AI, as part of the process. The editorial team saw this content before its publication.