Acral lentiginous melanoma: Who benefits from sentinel lymph node biopsy?

Takamichi Ito, Maiko Wada, Konosuke Nagae, Misa Nakano-Nakamura, Takeshi Nakahara, Akihito Hagihara, Masutaka Furue, Hiroshi Uchi

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Abstract

Background There are significant clinicopathological, genetic, and biological differences between acral lentiginous melanoma (ALM) and other types of melanoma. Objective We sought to investigate the use of sentinel lymph node (SLN) biopsy for patients with ALM.

Methods This was a retrospective review of 116 patients with primary ALM. Melanoma-specific and disease-free survival were estimated using the Kaplan-Meier method, together with multivariate analyses using the Cox proportional hazards regression model.

Results All patients were Japanese (48 male and 68 female). Metastases in SLN were noted in 13 of 84 patients who underwent SLN biopsy. No patients with thin ALM (≤1 mm) and only 2 patients with nonulcerated ALM had tumor-positive SLN. Patients with positive SLN had significantly shorter melanoma-specific survival (5-year survival rate, 37.5% vs 84.3%; P <.0001) and disease-free survival (5-year survival, 37.5% vs 77.9%; P =.0024). Among patients with thick (>1 mm) ALM, the influence of SLN positivity on melanoma-specific survival was increased (5-year survival, 22.7% vs 80.8%; P =.0005).

Limitations This was a retrospective study and had a small sample size.

Conclusions SLN biopsy should be considered for patients with thick or ulcerated ALM. For patients with thin or nonulcerated ones, it may be of limited importance.

Original languageEnglish
Pages (from-to)71-77
Number of pages7
JournalJournal of the American Academy of Dermatology
Volume72
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

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Sentinel Lymph Node Biopsy
Melanoma
Extremities
Survival
Proportional Hazards Models
Sample Size
Disease-Free Survival
Multivariate Analysis
Survival Rate
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Dermatology

Cite this

Acral lentiginous melanoma : Who benefits from sentinel lymph node biopsy? / Ito, Takamichi; Wada, Maiko; Nagae, Konosuke; Nakano-Nakamura, Misa; Nakahara, Takeshi; Hagihara, Akihito; Furue, Masutaka; Uchi, Hiroshi.

In: Journal of the American Academy of Dermatology, Vol. 72, No. 1, 01.01.2015, p. 71-77.

Research output: Contribution to journalArticle

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abstract = "Background There are significant clinicopathological, genetic, and biological differences between acral lentiginous melanoma (ALM) and other types of melanoma. Objective We sought to investigate the use of sentinel lymph node (SLN) biopsy for patients with ALM.Methods This was a retrospective review of 116 patients with primary ALM. Melanoma-specific and disease-free survival were estimated using the Kaplan-Meier method, together with multivariate analyses using the Cox proportional hazards regression model.Results All patients were Japanese (48 male and 68 female). Metastases in SLN were noted in 13 of 84 patients who underwent SLN biopsy. No patients with thin ALM (≤1 mm) and only 2 patients with nonulcerated ALM had tumor-positive SLN. Patients with positive SLN had significantly shorter melanoma-specific survival (5-year survival rate, 37.5{\%} vs 84.3{\%}; P <.0001) and disease-free survival (5-year survival, 37.5{\%} vs 77.9{\%}; P =.0024). Among patients with thick (>1 mm) ALM, the influence of SLN positivity on melanoma-specific survival was increased (5-year survival, 22.7{\%} vs 80.8{\%}; P =.0005).Limitations This was a retrospective study and had a small sample size.Conclusions SLN biopsy should be considered for patients with thick or ulcerated ALM. For patients with thin or nonulcerated ones, it may be of limited importance.",
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AU - Uchi, Hiroshi

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N2 - Background There are significant clinicopathological, genetic, and biological differences between acral lentiginous melanoma (ALM) and other types of melanoma. Objective We sought to investigate the use of sentinel lymph node (SLN) biopsy for patients with ALM.Methods This was a retrospective review of 116 patients with primary ALM. Melanoma-specific and disease-free survival were estimated using the Kaplan-Meier method, together with multivariate analyses using the Cox proportional hazards regression model.Results All patients were Japanese (48 male and 68 female). Metastases in SLN were noted in 13 of 84 patients who underwent SLN biopsy. No patients with thin ALM (≤1 mm) and only 2 patients with nonulcerated ALM had tumor-positive SLN. Patients with positive SLN had significantly shorter melanoma-specific survival (5-year survival rate, 37.5% vs 84.3%; P <.0001) and disease-free survival (5-year survival, 37.5% vs 77.9%; P =.0024). Among patients with thick (>1 mm) ALM, the influence of SLN positivity on melanoma-specific survival was increased (5-year survival, 22.7% vs 80.8%; P =.0005).Limitations This was a retrospective study and had a small sample size.Conclusions SLN biopsy should be considered for patients with thick or ulcerated ALM. For patients with thin or nonulcerated ones, it may be of limited importance.

AB - Background There are significant clinicopathological, genetic, and biological differences between acral lentiginous melanoma (ALM) and other types of melanoma. Objective We sought to investigate the use of sentinel lymph node (SLN) biopsy for patients with ALM.Methods This was a retrospective review of 116 patients with primary ALM. Melanoma-specific and disease-free survival were estimated using the Kaplan-Meier method, together with multivariate analyses using the Cox proportional hazards regression model.Results All patients were Japanese (48 male and 68 female). Metastases in SLN were noted in 13 of 84 patients who underwent SLN biopsy. No patients with thin ALM (≤1 mm) and only 2 patients with nonulcerated ALM had tumor-positive SLN. Patients with positive SLN had significantly shorter melanoma-specific survival (5-year survival rate, 37.5% vs 84.3%; P <.0001) and disease-free survival (5-year survival, 37.5% vs 77.9%; P =.0024). Among patients with thick (>1 mm) ALM, the influence of SLN positivity on melanoma-specific survival was increased (5-year survival, 22.7% vs 80.8%; P =.0005).Limitations This was a retrospective study and had a small sample size.Conclusions SLN biopsy should be considered for patients with thick or ulcerated ALM. For patients with thin or nonulcerated ones, it may be of limited importance.

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