Annals of Surgical Oncology

, Volume 20, Issue 11, pp 3618–3625 | Cite as

Prognosis of Acral Melanoma: A Series of 281 Patients

  • Danielle M. Bello
  • Joanne F. Chou
  • Katherine S. Panageas
  • Mary S. Brady
  • Daniel G. Coit
  • Richard D. Carvajal
  • Charlotte E. Ariyan



Acral melanoma (AM) is an unusual malignancy with poor survival. This study defines a cohort of patients, treated at a single institution, and the factors associated with survival and comparison with nonacral cutaneous melanoma (NACM).


All patients with AM presenting from 1995 to 2010 were identified from a prospectively maintained database. Analysis of clinicopathologic features of AM associated with disease-specific survival (DSS) was performed. A stratified, stage-matched survival analysis compared the outcome of 281 acral to 843 extremity NACM patients.


A total of 281 AM patients (170 volar, 111 subungual) were identified. Pathologic stage (p < 0.001), ulceration (p < 0.001), Breslow thickness (p < 0.001), and a positive sentinel lymph node (p < 0.001) were found to be poor prognostic indicators associated with DSS. In stage-matched analysis, AM had a worse DSS compared with NACM (hazard ratio 1.8; 95 % CI 1.2–2.7; p < 0.01).


This study represents the largest, single-institution series describing the characteristics and outcomes of AM. AM tumors exhibit aggressive histopathologic features associated with a poorer survival outcome. AM patients have an inferior survival than extremity NACM when matched for stage, perhaps reflecting inherent alterations in tumor biology. This warrants further investigation into the differences between acral and cutaneous melanoma.


Melanoma Sentinel Lymph Node Sentinel Lymph Node Biopsy Cutaneous Melanoma Positive Sentinel Lymph Node 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank Kita Bogatch and the Melanoma Disease Management Team for their significant contributions to this study.


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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Danielle M. Bello
    • 1
  • Joanne F. Chou
    • 3
  • Katherine S. Panageas
    • 3
  • Mary S. Brady
    • 1
  • Daniel G. Coit
    • 1
  • Richard D. Carvajal
    • 2
  • Charlotte E. Ariyan
    • 1
  1. 1.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of Medical OncologyMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  3. 3.Department of Epidemiology and BiostatisticsMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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