Treatment and Outcomes of Melanoma in Acral Location in Korean Patients
2
조회
0
다운로드
7
인용
0
참고문헌
키워드
초록
Purpose: A retrospective study was conducted to review the treatment and outcomes of mainly melanomas in acral location in a single institution in Korea, and to evaluate the prognostic significance of anatomic locations of the tumor. Materials and Methods: A retrospective review was completed on 40 patients between 2001 and 2006 to obtain pertinent demographic data, tumor data, treatment characteristics,and follow-up data. Results: Forty melanoma patients were identified and analyzed. Of these, 18 were male and 22 were female patients and the mean age at the time of diagnosis was 55.9 years. Of the tumors, 65% were located on the hands and feet with acral lentiginous melanoma being the most common histological subtype. Univariate analysis for the overall melanoma survival revealed that the thickness of the tumor and the clinical stage have prognostic significances. The most significant factor as analyzed by a multivariate analysis was shown to be the advanced clinical stage. Acral melanomas did not show statistically significant differences in the age at diagnosis, thickness of the tumor, stage, ulceration, and survival rates compared to non-acral melanomas. There was also no significant difference in the survival rate between the patients treated by amputation versus wide local excision in acral melanomas. Conclusion: In Korean melanoma patients, thickness and advanced stages are significant factors for poorer prognosis. However, the location of melanoma did not have a significant prognostic value. In treating the melanomas in acral location, local wide excisions resulted in a similar prognosis compared to amputations.
Abstract
Purpose: A retrospective study was conducted to review the treatment and outcomes of mainly melanomas in acral location in a single institution in Korea, and to evaluate the prognostic significance of anatomic locations of the tumor. Materials and Methods: A retrospective review was completed on 40 patients between 2001 and 2006 to obtain pertinent demographic data, tumor data, treatment characteristics,and follow-up data. Results: Forty melanoma patients were identified and analyzed. Of these, 18 were male and 22 were female patients and the mean age at the time of diagnosis was 55.9 years. Of the tumors, 65% were located on the hands and feet with acral lentiginous melanoma being the most common histological subtype. Univariate analysis for the overall melanoma survival revealed that the thickness of the tumor and the clinical stage have prognostic significances. The most significant factor as analyzed by a multivariate analysis was shown to be the advanced clinical stage. Acral melanomas did not show statistically significant differences in the age at diagnosis, thickness of the tumor, stage, ulceration, and survival rates compared to non-acral melanomas. There was also no significant difference in the survival rate between the patients treated by amputation versus wide local excision in acral melanomas. Conclusion: In Korean melanoma patients, thickness and advanced stages are significant factors for poorer prognosis. However, the location of melanoma did not have a significant prognostic value. In treating the melanomas in acral location, local wide excisions resulted in a similar prognosis compared to amputations.
참고문헌 (41)
- Jemal A, "Cancer statistics, 2002", CA Cancer J Clin, 52, pp.23~47 (2002)
- Dooley TP, "Recent advances in cutaneous melanoma oncogenesis research", Oncol Res, 6, pp.1~9 (1994)
- Chen YJ, "Clinicopathologic analysis of malignant melanoma in Taiwan", J Am Acad Dermatol, 41, pp.945~949 (1999)
- Chang AE, "The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society", Cancer, 83, pp.1664~1678 (1998)
- Luk NM, "Clinicopathological features and prognostic factors of cutaneous melanoma among Hong Kong Chinese", Clin Exp Dermatol, 29, pp.600~604 (2004)
- Ishihara K, "Updated statistical data for malignant melanoma in Japan", Int J Clin Oncol, 6, pp.109~116 (2001)
- 이미우, "한국인에서의 악성 흑색종에 대한 임상 및 병리 조직학적 연구 - 대한피부과학회 피부병리연구분과위원회 공동연구-", 대한피부과학회지, 41(1), pp.43~47 (2003), 대한피부과학회
- Moon SE, "A statistical study of cutaneous malignant tumors", Korean J Dermatol, 36, pp.7~15 (1998)
- Hemmings DE, "Cutaneous melanoma in a multiethnic population: is this a different disease?", Arch Surg, 139, pp.968~972 (2004)
- Balch CM, "The new melanoma staging system", Tumori, 87, pp.S64~68 (2001)
- Cormier JN, "Ethnic differences among patients with cutaneous melanoma", Arch Intern Med, 166, pp.1907~1914 (2006)
- Jang KA, "A Clinico-histopathological study of malignant melanoma", Korean J Dermatol, 38, pp.1435~1443 (2000)
- 박경덕, "피부 악성 흑색종의 임상 및 병리조직학적 소견", 대한피부과학회지, 45(2), pp.149~158 (2007), 대한피부과학회
- 이동훈, "최근 12년간 악성 흑색종의 임상 및 병리조직학적 연구", 대한피부과학회지, 40(8), pp.914~923 (2002), 대한피부과학회
- Ries LA, "The annual report to the nation on the status of cancer, 1973-1997, with a special section on colorectal cancer", Cancer, 88, pp.2398~2424 (2000)
- Boyle P, "Epidemiology of malignant melanoma", Br Med Bull, 51, pp.523~547 (1995)
- Tsai T, "Cutaneous, ocular and visceral melanoma in African Americans and Caucasians", Melanoma Res, 15, pp.213~217 (2005)
- Morton DL, "Multivariate analysis of the relationship between survival and the microstage of primary melanoma by Clark level and Breslow thickness", Cancer, 71, pp.3737~3743 (1993)
- Garbe C, "Primary cutaneous melanoma. Identification of prognostic groups and estimation of individual prognosis for 5093 patients", Cancer, 75, pp.2484~2491 (1995)
- Vollmer RT, "Malignant melanoma. A multivariate analysis of prognostic factors", Pathol Annu, 24, pp.383~407 (1989)
- Breslow A, "Tumor thickness, level of invasion and node dissec-tion in stage I cutaneous melanoma", Ann Surg, 182, pp.572~575 (1975)
- Bevilacqua RG, "Axillary dissection in melanoma. Prognostic variables in nodepositive patients", Ann Surg, 212, pp.125~131 (1990)
- Hu S, "UV radiation, latitude, and melanoma in US Hispanics and blacks", Arch Dermatol, 140, pp.819~824 (2004)
- Jemal A, "Cancer statistics, 2005", CA Cancer J Clin, 55, pp.10~30 (2005)
- Rhodes AR, "Risk factors for cutaneous melanoma. A practical method of recognizing predisposed individuals", JAMA, 258, pp.3146~3154 (1987)
- Holly EA, "Cutaneous melanoma in women. I. Exposure to sunlight, ability to tan, and other risk factors related to ultraviolet light", Am J Epidemiol, 141, pp.923~933 (1995)
- Elwood JM, "Melanoma and sun exposure", Semin Oncol, 23, pp.650~666 (1996)
- Gloster HM Jr, "Skin cancer in skin of color", J Am Acad Dermatol, 55, pp.741~760 (2006)
- McCredie M, "Cancer incidence in migrants to New South Wales from England, Wales, Scotland and Ireland", Br J Cancer, 62, pp.992~995 (1990)
- Cooke KR, "Migration and death from malignant melanoma", Int J Cancer, 36, pp.175~178 (1985)
- Titus-Ernstoff L, "An overview of the epidemiology of cutaneous melanoma", Clin Plast Surg, 27, pp.305~316 (2000)
- Halder RM, "Skin cancer in African Americans", Cancer, 75, pp.667~673 (1995)
- Stevens NG, "Plantar melanoma: is the incidence of melanoma of the sole of the foot really higher in blacks than whites?", Int J Cancer, 45, pp.691~693 (1990)
- Kuchelmeister C, "Acral cutaneous melanoma in caucasians: clinical features, histopathology and prognosis in 112 patients", Br J Dermatol, 143, pp.275~280 (2000)
- Wells KE, "The current management and prognosis of acral lentiginous melanoma", Ann Plast Surg, 28, pp.100~103 (1992)
- Tseng JF, "Surgical management of primary cutaneous melanomas of the hands and feet", Ann Surg, 225, pp.544~550 (1997)
- Daly JM, "Subungual melanoma: a 25-year review of cases", J Surg Oncol, 35, pp.107~112 (1987)
- Moehrle M, "“Functional” surgery in subungual melanoma", Dermatol Surg, 29, pp.366~374 (2003)
- Franke W, "Plantar malignant melanoma--a challenge for early recognition", Melanoma Res, 10, pp.571~576 (2000)
- Bennett DR, "The effect of misdiagnosis and delay in diagnosis on clinical outcome in melanomas of the foot", J Am Coll Surg, 179, pp.279~284 (1994)
- Kato T, "Improvement in survival rate of patients with acral melanoma observed in the past 22 years in Sendai, Japan", Clin Exp Dermatol, 18, pp.107~110 (1993)
