Clinicopathological Characteristics and Prognostic Factors of Malignant Melanoma
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Abstract
Background: Although malignant melanoma (MM) is a rare disease in Asia but possess the most common cause of mortality among skin cancers. Thailand lacks of clearly evidence report and less in clinical studies of MM. The purpose of study is to describe the clinicopathological characteristics and define possible prognostic factors of MM in Thai patients.
Methods: A retrospective cohort study was conducted at Surin Hospital between January 2005 and December 2016. All medical records were reviewed for demographic data and histopathological features. Kaplan-Meier model was used for survival time analysis. Prognostic factors according to clinicopathological features Were performed by univariate and multivariate analysis.
Results: Fifty-one patients with pathologically confirmed malignant melanoma were included in the study. The mean age of onset was 65.4 years and slightly predominant in male (58.8%). Newly seen abnormal skin lesion (75.5%) and palmoplantar site (72.6%) were the most presenting symptom and primary location. The median time to diagnosis was 8 months. Majority of patients had clinical stage III (50%). Acral lentiginous melanoma (ALM) was the most common subtype (51.6%), while not found any superficial spreading melanoma (SSM) and lentigo maligna melanoma (LMM). Median survival time (MST) and 3-year overall survival rate were 1.9 years and 35.7%, respectively. According to 7th AJCC staging system, MST of stage III and IV were poor (1.67 years and 0.21 years). Univariate analysis demonstrated that increasing age, non ALM subtypes and stage lll-IV were bad prognostic factors. Only non ALM subtypes were the independent risk factor for poor prognosis (HR 364.46, p=0.05) by multivariate analysis.
Conclusion: Malignant melanoma in Thai patients, ALM was the most common histological subtype and were diagnosed with locally advanced disease (stage III) with poor survival. The prognosis depends on histological subtype.
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References
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