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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2025-05-01
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| author | J. Angel-Baldo S. Podlipnik A. Azón A. Boada A. Arrieta J. Marcoval C. López-Sánchez M. Sàbat S. Segura D. Bodet N. Curcó D. Lopez-Castillo J. Solà M. Quintana-Codina C. Baliu-Piqué M. Just-Sarobé S. Martín-Sala J. Malvehy S. Puig C. Carrera R.M. Marti Clara Matas-Nadal Xavier Soria Sonia Gatius Felip Vilardell Inma Gil Cristina Grau Fani Martínez Nelson Lobos Oriol Yélamos Joan Dalmau Carlos González-Cruz Helena Hilari Paola Pasquali Marc Sagristà María Rosa Olivella-Garcés Montserrat Bonfill-Ortí Josep Ramón Ferreres Ane Jaka Ariadna Quer Nina Richarz Inés Zarzoso Muñoz Emili Masferrer Pedro Zaballos Manel Formigon Loida Galvany Marta Alegre Anna Sánchez-Puigdollers Nerea Mohino-Farré |
| author_facet | J. Angel-Baldo S. Podlipnik A. Azón A. Boada A. Arrieta J. Marcoval C. López-Sánchez M. Sàbat S. Segura D. Bodet N. Curcó D. Lopez-Castillo J. Solà M. Quintana-Codina C. Baliu-Piqué M. Just-Sarobé S. Martín-Sala J. Malvehy S. Puig C. Carrera R.M. Marti Clara Matas-Nadal Xavier Soria Sonia Gatius Felip Vilardell Inma Gil Cristina Grau Fani Martínez Nelson Lobos Oriol Yélamos Joan Dalmau Carlos González-Cruz Helena Hilari Paola Pasquali Marc Sagristà María Rosa Olivella-Garcés Montserrat Bonfill-Ortí Josep Ramón Ferreres Ane Jaka Ariadna Quer Nina Richarz Inés Zarzoso Muñoz Emili Masferrer Pedro Zaballos Manel Formigon Loida Galvany Marta Alegre Anna Sánchez-Puigdollers Nerea Mohino-Farré |
| author_sort | J. Angel-Baldo |
| collection | DOAJ |
| 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. Resumen: 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 localizados 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 menor supervivencia específica por melanoma. Un mayor grosor de Breslow y la ulceración fueron los factores pronósticos independientes menor 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 a distancia apareciendo antes que las recurrencias locorregionales (1,32 años [IQR: 1,12-1,87] vs. 2,14 años [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 a distancia tempranas enfatizan el papel crítico del seguimiento intensivo y las pruebas de imagen rutinarias para detectar recaídas asintomáticas. |
| format | Article |
| id | doaj-art-92f2eb19ce4940bcbc94d9e070ab5874 |
| institution | OA Journals |
| issn | 0001-7310 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
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| series | Actas Dermo-Sifiliográficas |
| spelling | doaj-art-92f2eb19ce4940bcbc94d9e070ab58742025-08-20T02:30:55ZengElsevierActas Dermo-Sifiliográficas0001-73102025-05-01116546247310.1016/j.ad.2024.10.060Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic FeaturesJ. Angel-Baldo0S. Podlipnik1A. Azón2A. Boada3A. Arrieta4J. Marcoval5C. López-Sánchez6M. Sàbat7S. Segura8D. Bodet9N. Curcó10D. Lopez-Castillo11J. Solà12M. Quintana-Codina13C. Baliu-Piqué14M. Just-Sarobé15S. Martín-Sala16J. Malvehy17S. Puig18C. Carrera19R.M. Marti20Clara Matas-Nadal21Xavier Soria22Sonia Gatius23Felip Vilardell24Inma Gil25Cristina Grau26Fani Martínez27Nelson Lobos28Oriol Yélamos29Joan Dalmau30Carlos González-Cruz31Helena Hilari32Paola Pasquali33Marc Sagristà34María Rosa Olivella-Garcés35Montserrat Bonfill-Ortí36Josep Ramón Ferreres37Ane Jaka38Ariadna Quer39Nina Richarz40Inés Zarzoso Muñoz41Emili Masferrer42Pedro Zaballos43Manel Formigon44Loida Galvany45Marta Alegre46Anna Sánchez-Puigdollers47Nerea Mohino-Farré48Department of Dermatology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Reus, Catalonia, Spain; Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Catalonia, Spain; Corresponding author.Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, IDIBAPS, Barcelona, Catalonia, SpainDepartment of Dermatology, Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Reus, Catalonia, SpainDepartment of Dermatology, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Catalonia, SpainDepartment of Dermatology, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Catalonia, SpainDepartment of Dermatology, Hospital Universitari de Bellvitge, Barcelona, Catalonia, SpainDepartment of Dermatology, Hospital de la Santa Creu i Sant Pau, IIB SANT PAU, Universitat Autònoma de Barcelona, Barcelona, Catalonia, SpainDepartment of Dermatology, Hospital Universitari Parc Taulí, Sabadell, Catalonia, SpainDepartment of Dermatology, Hospital del Mar, Hospital del Mar Research Institute-IMIM, Universitat Pompeu Fabra, Barcelona, Catalonia, SpainDepartment of Dermatology, Hospital Universitari Vall d’Hebrón, Barcelona, Catalonia, SpainDepartment of Dermatology, Hospital Universitari Mutua Terrassa, Terrassa, Catalonia, SpainDepartment of Dermatology, Hospital Moises Broggi, Sant Joan Despí, Catalonia, SpainDepartment of Dermatology, Hospital General de Granollers, Granollers, Catalonia, SpainDepartment of Dermatology, Hospital Universitari Sagrat Cor, Grupo Quironsalud, Barcelona, Catalonia, SpainDepartment of Dermatology, Hospital Universitari d’Igualada, Igualada, Catalonia, SpainDepartment of Dermatology, Hospital Universitari Joan XXIII, Tarragona, Catalonia, SpainDepartment of Dermatology, Hospital Dos de Maig, Barcelona, Catalonia, SpainDepartment of Dermatology, Hospital Clínic Barcelona, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, SpainDepartment of Dermatology, Hospital Clínic Barcelona, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, SpainDepartment of Dermatology, Hospital Clínic Barcelona, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, Spain; Corresponding author.Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Catalonia, Spain; Centre of Biomedical Research on Cancer (CIBERONC), Instituto de Salud Carlos III (ISCIII), Madrid, SpainHospital Universitari Arnau de Vilanova, LleidaHospital Universitari Arnau de Vilanova, LleidaHospital Universitari Arnau de Vilanova, LleidaHospital Universitari Arnau de Vilanova, LleidaHospital Universitari Sant Joan de ReusHospital Universitari Sant Joan de ReusHospital Universitari Sant Joan de ReusHospital Clínic de Barcelona, BarcelonaHospital de la Santa Creu i Sant Pau, BarcelonaHospital de la Santa Creu i Sant Pau, BarcelonaHospital Universitari Vall d’HebrónHospital Universitari Vall d’HebrónPius Hospital de VallsHospital de CalellaHospital Moisès Broggi, Consorci Sanitari Integral, Sant Joan DespíHospital Universitari de BellvitgeHospital Universitari de BellvitgeHospital Universitari Germans Trias i Pujol, BadalonaHospital Universitari Germans Trias i Pujol, BadalonaHospital Universitari Germans Trias i Pujol, BadalonaHospital Universitari Mútua TerrassaHospital Universitari Mútua TerrassaHospital Sant Pau i Santa Tecla, TarragonaConsorci Sanitari de TerrassaHospital Dos de MaigHospital Plató, BarcelonaHospital Joan XXIII, TarragonaHospital Joan XXIII, TarragonaBackground: 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. Resumen: 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 localizados 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 menor supervivencia específica por melanoma. Un mayor grosor de Breslow y la ulceración fueron los factores pronósticos independientes menor 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 a distancia apareciendo antes que las recurrencias locorregionales (1,32 años [IQR: 1,12-1,87] vs. 2,14 años [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 a distancia tempranas enfatizan el papel crítico del seguimiento intensivo y las pruebas de imagen rutinarias para detectar recaídas asintomáticas.http://www.sciencedirect.com/science/article/pii/S0001731025000018Melanoma acralFactor de riesgoFactor pronósticoMelanoma cutáneoAnálisis de supervivenciaMelanoma de pie |
| spellingShingle | J. Angel-Baldo S. Podlipnik A. Azón A. Boada A. Arrieta J. Marcoval C. López-Sánchez M. Sàbat S. Segura D. Bodet N. Curcó D. Lopez-Castillo J. Solà M. Quintana-Codina C. Baliu-Piqué M. Just-Sarobé S. Martín-Sala J. Malvehy S. Puig C. Carrera R.M. Marti Clara Matas-Nadal Xavier Soria Sonia Gatius Felip Vilardell Inma Gil Cristina Grau Fani Martínez Nelson Lobos Oriol Yélamos Joan Dalmau Carlos González-Cruz Helena Hilari Paola Pasquali Marc Sagristà María Rosa Olivella-Garcés Montserrat Bonfill-Ortí Josep Ramón Ferreres Ane Jaka Ariadna Quer Nina Richarz Inés Zarzoso Muñoz Emili Masferrer Pedro Zaballos Manel Formigon Loida Galvany Marta Alegre Anna Sánchez-Puigdollers Nerea Mohino-Farré Acral Melanoma in the Caucasian Population: A Comprehensive Cohort Study on Epidemiological, Clinicopathological, and Prognostic Features Actas Dermo-Sifiliográficas Melanoma acral Factor de riesgo Factor pronóstico Melanoma cutáneo Análisis de supervivencia Melanoma de pie |
| 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 | Melanoma acral Factor de riesgo Factor pronóstico Melanoma cutáneo Análisis de supervivencia Melanoma de pie |
| url | http://www.sciencedirect.com/science/article/pii/S0001731025000018 |
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