Digit melanomas are associated with poor prognostic factors and unfavorable survivals

Abstract

Background: The anatomic location of primary melanoma is significantly associated with outcome. Objective: To evaluate the prognostic factors and survival outcomes associated with melanomas on hand and foot digits. Methods: The data of 106 patients with digit melanomas were analyzed retrospectively. Results: Median age of patients was 55 years, and male-to-female ratio was one. Majority of the patients had skin melanomas (74.5%); and 25.5% of them had ungual melanomas. The lesions slightly more frequently affected toes (53.8%) and thumbs (55.9%); and 57.4% of the lesions were right-sided. Acral lentiginous melanoma was the major histological subtype (67.5%). Digit melanomas were associated with aggressive histological features, such as high Clark level (75%), thick Breslow depth (72.3%), presence of ulceration (74.3%), and high mitotic rate (58.3%). At admission, the rates of stage I-II, stage III, and stage IV diseases were 57.6%, 33%, and 9.4%, respectively. The recurrence and mortality rates were 41.7% and 46.2%, respectively. The 5-year RFS and OS rates were similar: 47%. Melanoma origins (skin vs. ungual), locations (finger vs. toe; first digit vs. others; and right vs. left), and histological subtypes (acral lentiginous melanoma vs. others) had no impact on survivals. The known poor prognostic histological factors, such as Clark level, Breslow thickness, mitotic rate, ulceration, and neurotropism, were found to be associated with both RFS and OS. Conclusion: Digit melanomas are associated with poor clinicopathological prognostic features, and they might predict unfavorable survivals.