The risk factors affecting acral melanoma metastasis and prognosis remain unclear. The study included 168 patients with invasive acral melanoma who were followed for ≥3 years. We evaluated patient demographics, stages, clinicopathological features, anatomic site of melanoma including nail versus volar surface, and degree of melanoma pigmentations, sentinel lymph node biopsy results, and the first metastasis sites. Of the 168 patients (mean age 64.5 years; 52.4% male), 43 (25.6%) had invasive melanoma without metastasis, 113 (67.3%) had invasive melanoma with a first lymph node metastasis, and 12 (7.1%) had invasive melanoma with invasive melanoma with a first distant metastasis. Advanced T stage, high mitotic rate, ulceration, and the degree of pigmentation were significant risk factors for metastasis. Amelanotic and mild pigmentation of acral melanoma was associated with first distant metastasis, whereas heavy pigmentation was associated with first lymph node metastasis. Advanced TNM stages, high mitotic rate, volar location (hazard ratio = 2.24, 95% confidence interval 1.18–4.26), and low-pigmentation (hazard ratio = 2.02, 95% confidence interval 1.17–3.49) were associated with melanoma-specific mortality.

中文翻译：

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掌侧位置和色素沉着程度与肢端黑色素瘤的不良生存率和首次转移模式相关


影响肢端黑色素瘤转移和预后的危险因素仍不清楚。该研究纳入了 168 名侵袭性肢端黑色素瘤患者，随访时间≥3 年。我们评估了患者的人口统计、分期、临床病理特征、黑色素瘤的解剖部位（包括指甲与掌侧表面）、黑色素瘤色素沉着程度、前哨淋巴结活检结果和首次转移部位。在 168 名患者（平均年龄 64.5 岁；52.4% 男性）中，43 名（25.6%）患有无转移的侵袭性黑色素瘤，113 名（67.3%）患有具有第一淋巴结转移的侵袭性黑色素瘤，12 名（7.1%）患有侵袭性黑色素瘤患有首次远处转移的侵袭性黑色素瘤。 T分期晚期、高有丝分裂率、溃疡和色素沉着程度是转移的重要危险因素。肢端黑色素瘤的无黑色素和轻度色素沉着与首次远处转移相关，而重度色素沉着与首次淋巴结转移相关。晚期 TNM 分期、高有丝分裂率、掌侧位置（风险比 = 2.24，95% 置信区间 1.18–4.26）和低色素沉着（风险比 = 2.02，95% 置信区间 1.17–3.49）与黑色素瘤特异性死亡率相关。