Acral Lentiginous Melanoma Is Associated with Certain Poor Prognostic Histopathological Factors but May Not be Correlated with Nodal Involvement, Recurrence, and a Worse Survival

Abstract

Background/Aims: Acral lentiginous melanoma (ALM) is a small subtype of melanoma affecting Caucasians far more often than other ethnic groups, such as blacks, Hispanics, and Asians. Only a few studies have yielded controversial results on ALM so far. The aim of this study was to define the histopathological and clinical expressions of ALM and to compare them with those of non-ALM in a large group of Turkish patients from a single referral institution. Methods: One hundred two ALM patients were analyzed retrospectively. Results: The median age of the patients was 58 years. The lower limbs (the thigh and leg as well as the foot) were predominantly affected (78%) and cases were mostly nonungual (89%). ALM were found more frequently in females (p = 0.04). They were ulcerated (p = 0.0001), they were associated with neurotropism (p = 0.0001), they lacked the BRAF mutation (p = 0.03), and they less often coexisted with a preceding melanocytic nevus (p = 0.0001). No correlations were found between ALM and either nodal involvement or distant metastasis. The recurrence-free survival and overall survival rates for ALM patients were similar to those of patients with other histopathologies. The 5-year recurrence-free survival and 5-year overall survival rates for ALM patients were 58.7 and 59%, respectively. Conclusion: Although ALM is associated with some aggressive histopathological factors, it may not correlated with nodal involvement, recurrence, or poor survival. (C) 2018 S. Karger AG, Basel