Acral lentiginous melanoma (ALM) is a rare histological subtype of cutaneous malignant melanoma that typically presents on the palms and soles. To characterize the demographic and treatment characteristics of ALM, we used the National Cancer Database (NCDB) to describe a large multi-institutional cohort of ALM patients, consisting of 4,796 ALM patients from 2004 to 2015. ALM was more likely to be diagnosed at a later stage overall compared with non-ALM cutaneous melanomas, and more likely to be thicker, ulcerated, lymph node positive, and have lymphovascular invasion and positive margins. When stratified by stage, ALM had worse survival compared with non-ALM patients, most notably in stage III patients with 5-year survival of 47.5% versus 56.7%, respectively (p < .001). In ALM patients, older age, male sex, higher comorbidity burden, increased tumor thickness and ulceration, positive lymph nodes, and positive metastasis were independently associated with lower 5-year survival. Multimodality therapy, defined as surgery in addition to systemic therapy and/or radiation therapy, was associated with higher survival in stage III patients but not in other stages. These results call for further investigation into possible treatment intensification in the ALM population in the future.

中文翻译：

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肢端雀斑样黑色素瘤 — 使用 NCDB 2004 年至 2015 年的人口、治疗和生存情况


肢端雀斑样黑色素瘤 (ALM) 是一种罕见的皮肤恶性黑色素瘤组织学亚型，通常出现在手掌和脚底。为了描述 ALM 的人口统计学和治疗特征，我们使用国家癌症数据库 (NCDB) 来描述一个大型多机构 ALM 患者队列，其中包括 2004 年至 2015 年的 4,796 名 ALM 患者。ALM 更有可能在总体而言，与非ALM皮肤黑色素瘤相比，晚期阶段更可能增厚、溃疡、淋巴结阳性、有淋巴管侵犯和切缘阳性。按阶段分层时，与非 ALM 患者相比，ALM 患者的生存率较差，尤其是 III 期患者，5 年生存率分别为 47.5% 和 56.7% ( p < .001)。在 ALM 患者中，年龄较大、男性、较高的合并症负担、肿瘤厚度和溃疡增加、淋巴结阳性和转移阳性与较低的 5 年生存率独立相关。多学科治疗（定义为除全身治疗和/或放射治疗外的手术）与 III 期患者的较高生存率相关，但与其他阶段的患者无关。这些结果要求进一步调查未来 ALM 人群可能的强化治疗。