Acral Lentiginous Melanoma: Do Surgical Approach and Sentinel Lymph Node Biopsy Matter?

Plastic and Reconstructive Surgery. Global Open
Marc E WalkerDale Han

Abstract

Management of acral lentiginous melanoma (ALM) remains controversial. Traditionally, ALM was managed with digit amputation (DA), resulting in significant morbidity, but recent evidence has advocated for digit sparing management. Furthermore, the significance of nodal metastasis for ALM is not well reported. The aims of this study were to determine if surgical approach for primary ALM impacts outcomes and to evaluate the predictive value of nodal status for ALM. Patients with localized ALM diagnosed from 1982 to 2017 were retrospectively identified. Clinicopathologic characteristics were correlated with surgical approach, nodal metastasis, overall survival, and recurrence-free survival. There were 47 patients with ALM. Median age was 59 years, and median thickness was 3 mm. 51% of patients underwent wide local excision (WLE), 27.9% underwent DA, and 20.9% underwent partial digit amputation (PDA). ALM on the hand versus foot (OR: 12.7, 95%, confidence interval (CI), 2.0-80.1; P = 0.007) and subungual versus nonsubungual location (OR: 28.0, 95% confidence interval, 2.7-295.7; P = 0.006) were significantly associated with surgical approach (DA and PDA versus WLE). There were no significant differences in overall survival or recurre...Continue Reading

References

Dec 1, 1992·Annals of Surgery·K G ParkN M Kernohan
Sep 1, 1993·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·D L MortonA Cochran
Jul 1, 1996·CA: a Cancer Journal for Clinicians·M M Urist
Aug 16, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·C M BalchA Morabito
May 4, 2002·British Journal of Plastic Surgery·J H W ClarksonB Powell
Apr 1, 1965·Annals of Surgery·T DASGUPTA, R BRASFIELD
Aug 17, 2006·The British Journal of Dermatology·A PhanL Thomas
Sep 29, 2006·The New England Journal of Medicine·Donald L MortonUNKNOWN MSLT Group
May 9, 2007·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Sukh S RayattPaul M Davison
Dec 19, 2007·American Journal of Surgery·Tzeela CohenMary S Brady
Apr 22, 2009·Archives of Dermatology·Porcia T BradfordMargaret A Tucker
Apr 25, 2009·Journal of the American Academy of Dermatology·Charles M BalchJohn F Thompson
May 26, 2010·Yonsei Medical Journal·Mi Ryung RohKee Yang Chung
May 10, 2011·Clinics in Laboratory Medicine·Melissa Peck Piliang
Aug 27, 2011·Journal of the American Academy of Dermatology·Christopher K BichakjianUNKNOWN American Academy of Dermatology
Apr 16, 2013·Journal of the National Comprehensive Cancer Network : JNCCN·Daniel G CoitUNKNOWN National Comprehensive Cancer Network (NCCN)
Jul 11, 2013·Annals of Surgical Oncology·Danielle M BelloCharlotte E Ariyan
Feb 14, 2014·The New England Journal of Medicine·Donald L MortonUNKNOWN MSLT Group
Dec 3, 2014·Journal of the American Academy of Dermatology·Takamichi ItoHiroshi Uchi
Dec 17, 2014·Journal of the National Comprehensive Cancer Network : JNCCN·Priyanka V GumasteJennifer A Stein
Jun 18, 2015·JAMA Dermatology·Michael A MarchettiAllan C Halpern
Nov 26, 2015·Cancer Treatment and Research·James S Goydos, Steven L Shoen
Apr 10, 2016·Journal of the National Comprehensive Cancer Network : JNCCN·Daniel G Coit
Aug 9, 2016·Journal of the National Comprehensive Cancer Network : JNCCN·Daniel G CoitAnita Engh
Sep 20, 2016·Journal of Surgical Oncology·Kyeong-Tae LeeGoo-Hyun Mun
Sep 25, 2017·Clinical and Experimental Dermatology·A DesaiA Khachemoune
Dec 14, 2017·Clinical and Experimental Dermatology·A DesaiA Khachemoune

❮ Previous
Next ❯

Methods Mentioned

BETA
amputation
amputations
biopsy
dissection

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.