Acral Melanoma Incidence and Survival Trends in 1990–2020: A Nationwide, Population-based Study
DOI:
https://doi.org/10.2340/actadv.v104.40242Keywords:
Incidence, Melanoma, Survival RateAbstract
Acral melanoma is a clinical subtype of melanoma with high mortality, on which research is limited in scope. This study aimed to assess incidence trends and melanoma-specific survival rates for acral melanoma in the Swedish population from 1990 to 2020.This cross-sectional study included patients with an acral melanoma diagnosis from 1990 to 2020 from the nationwide, population-based Swedish Melanoma Registry. Analyses on acral melanoma melanoma-specific survival rates were adjusted for age, sex, histopathological subtype, and tumour thickness. Clinicopathological features and melanoma-specific survival rates were compared between diagnostic periods: 1990–1999, 2000–2009, and 2010–2020, respectively. Changes in standardized incidence rates in 1996–2020 were evaluated separately for males and females. In total, 1,000 acral melanomas in 999 patients were included in the study. No significant yearly change in standardized incidence rates for either males or females was observed, even though the absolute number of cases increased. Factors such as male sex, age ≥ 70 years, and Breslow thickness > 1.0 were independently linked to lower melanoma-specific survival. The 5-year melanoma-specific survival across the studied period ranged from 75.8% to 77.9% for females, and from 62.4% to 71.7% for males.
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Arnold M, Singh D, Laversanne M, Vignat J, Vaccarella S, Meheus F, et al. Global burden of cutaneous melanoma in 2020 and projections to 2040. JAMA Dermatol 2022; 158: 495-503.
https://doi.org/10.1001/jamadermatol.2022.0160
Vikström S, Mikiver R, Lapins J, Nielsen K, Vassilaki I, Lyth J, et al. Increasing melanoma incidence and survival trend shifts with improved melanoma-specific survival between 1990 and 2020 in Sweden. Br J Dermatol 2023; 189: 702-709.
https://doi.org/10.1093/bjd/ljad244
Elder DE, Bastian BC, Cree IA, Massi D, Scolyer RA. The 2018 World Health Organization classification of cutaneous, mucosal, and uveal melanoma: detailed analysis of 9 distinct subtypes defined by their evolutionary pathway. Arch Pathol Lab Med 2020; 144: 500-522.
https://doi.org/10.5858/arpa.2019-0561-RA
Tan KB, Moncrieff M, Thompson JF, McCarthy SW, Shaw HM, Quinn MJ, et al. Subungual melanoma: a study of 124 cases highlighting features of early lesions, potential pitfalls in diagnosis, and guidelines for histologic reporting. Am J Surg Pathol 2007; 31: 1902-1912.
https://doi.org/10.1097/PAS.0b013e318073c600
Soon SL, Solomon AR Jr, Papadopoulos D, Murray DR, McAlpine B, Washington CV. Acral lentiginous melanoma mimicking benign disease: the Emory experience. J Am Acad Dermatol 2003; 48: 183-188.
https://doi.org/10.1067/mjd.2003.63
Lv J, Dai B, Kong Y, Shen X, Kong J. Acral melanoma in Chinese: a clinicopathological and prognostic study of 142 cases. Sci Rep 2016; 6: 31432.
https://doi.org/10.1038/srep31432
Durbec F, Martin L, Derancourt C, Grange F. Melanoma of the hand and foot: epidemiological, prognostic and genetic features. A systematic review. Br J Dermatol 2012; 166: 727-739.
https://doi.org/10.1111/j.1365-2133.2011.10772.x
Bernardes SS, Ferreira I, Elder DE, Nobre AB, Martínez-Said H, Adams DJ, et al. More than just acral melanoma: the controversies of defining the disease. J Pathol Clin Res 2021; 7: 531-541.
https://doi.org/10.1002/cjp2.233
Jung HJ, Kweon SS, Lee JB, Lee SC, Yun SJ. A clinicopathologic analysis of 177 acral melanomas in Koreans: relevance of spreading pattern and physical stress. JAMA Dermatol 2013; 149: 1281-1288.
https://doi.org/10.1001/jamadermatol.2013.5853
Sheen YS, Liao YH, Lin MH, Chen JS, Liau JY, Tseng YJ, et al. A clinicopathological analysis of 153 acral melanomas and the relevance of mechanical stress. Sci Rep 2017; 7: 5564.
https://doi.org/10.1038/s41598-017-05809-9
Lee JH, Choi YD, Hwang JH, Shin MH, Yun SJ. Frequency of trauma, physical stress, and occupation in acral melanoma: analysis of 313 acral melanoma patients in Korea. Ann Dermatol 2021; 33: 228-236.
https://doi.org/10.5021/ad.2021.33.3.228
The Swedish Melanoma Registry - SweMR National annual report for cutaneous melanoma. Available from: https://cancercentrum.se/globalassets/om-rcc/sydost/pdf/nationell-kvalitetsregisterrapport-hudmelanom-1990-2021.pdf
Lyth J, Mikiver R, Nielsen K, Ingvar C, Olofsson Bagge R, Isaksson K. Population-based prognostic instrument (SweMR 2.0) for melanoma-specific survival: an ideal tool for individualised treatment decisions for Swedish patients. Eur J Surg Oncol 2023; 49: 106974.
https://doi.org/10.1016/j.ejso.2023.06.026
Gershenwald JE SR, Hess KR. AJCC cancer staging manual. 8th ed. New York: Springer Cham, 2017.
National Cancer Institute - Joinpoint Trend Analysis Software. Available from: https://surveillance.cancer.gov/joinpoint/
Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000; 19: 335-351.
https://doi.org/10.1002/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z
Eriksson H, Nielsen K, Vassilaki I, Lapins J, Mikiver R, Lyth J, et al. Trend shifts in age-specific incidence for in situ and invasive cutaneous melanoma in Sweden. Cancers (Basel) 2021; 13: 2838.
https://doi.org/10.3390/cancers13112838
Huang K, Fan J, Misra S. Acral lentiginous melanoma: incidence and survival in the United States, 2006-2015, an analysis of the SEER Registry. J Surg Res 2020; 251: 329-339.
https://doi.org/10.1016/j.jss.2020.02.010
Bradford PT, Goldstein AM, McMaster ML, Tucker MA. Acral lentiginous melanoma: incidence and survival patterns in the United States, 1986-2005. Arch Dermatol 2009; 145: 427-434.
https://doi.org/10.1001/archdermatol.2008.609
Csányi I, Houshmand N, Szűcs M, Ócsai H, Kemény L, Oláh J, et al. Acral lentiginous melanoma: a single-centre retrospective review of four decades in East-Central Europe. J Eur Acad Dermatol Venereol 2020; 34: 2004-2010.
https://doi.org/10.1111/jdv.16227
Raval NS, Hodges WT, Ugwu-Dike PO, Godoy F, Ansstas G, Cornelius LA, et al. Racial and socioeconomic differences in acral lentiginous melanoma outcomes: a surveillance, epidemiology, and end results analysis. J Am Acad Dermatol 2022; 87: 866-867.
https://doi.org/10.1016/j.jaad.2021.11.023
Arnold M, de Vries E, Whiteman DC, Jemal A, Bray F, Parkin DM, et al. Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012. Int J Cancer 2018; 143: 1305-1314.
https://doi.org/10.1002/ijc.31527
Erdei E, Torres SM. A new understanding in the epidemiology of melanoma. Expert Rev Anticancer Ther 2010; 10: 1811-1823.
https://doi.org/10.1586/era.10.170
Kurtansky NR, Dusza SW, Halpern AC, Hartman RI, Geller AC, Marghoob AA, et al. An epidemiologic analysis of melanoma overdiagnosis in the United States, 1975-2017. J Invest Dermatol 2022; 142: 1804-1811.e1806.
https://doi.org/10.1016/j.jid.2021.12.003
Matsumoto M, Wack S, Weinstock MA, Geller A, Wang H, Solano FX, et al. Five-year outcomes of a melanoma screening initiative in a large health care system. JAMA Dermatol 2022; 158: 504-512.
https://doi.org/10.1001/jamadermatol.2022.0253
Boriani F, O'Leary F, Tohill M, Orlando A. Acral lentiginous melanoma: misdiagnosis, referral delay and 5 years specific survival according to site. Eur Rev Med Pharmacol Sci 2014; 18: 1990-1996.
Mao L, Qi Z, Zhang L, Guo J, Si L. Immunotherapy in acral and mucosal melanoma: current status and future directions. Front Immunol 2021; 12: 680407.
https://doi.org/10.3389/fimmu.2021.680407
Elshanbary AA, Zaazouee MS, Abdelmonem M, Mohammed YA, Abdel-Aziz W. Risk factors for cardiovascular mortality and melanoma-specific mortality among patients with melanoma: a SEER based study. Eur J Cancer Prev 2022; 31: 293-300.
https://doi.org/10.1097/CEJ.0000000000000690
Morgese F, Sampaolesi C, Torniai M, Conti A, Ranallo N, Giacchetti A, et al. Gender differences and outcomes in melanoma patients. Oncol Ther 2020; 8: 103-114.
https://doi.org/10.1007/s40487-020-00109-1
Nader Marta G, Munhoz RR, Teixeira MP, Waldvogel BC, Pires de Camargo V, Feher O, et al. Trends in melanoma mortality in Brazil: a registry-based study. JCO Glob Oncol 2020; 6: 1766-1771.
https://doi.org/10.1200/GO.20.00426
Briatico G, Mancuso P, Argenziano G, Longo C, Mangone L, Moscarella E, et al. Trends in cutaneous melanoma mortality in Italy from 1982 to 2016. Int J Dermatol 2022; 61: 1237-1244.
https://doi.org/10.1111/ijd.16173
de Vries E, Nijsten TE, Visser O, Bastiaannet E, van Hattem S, Janssen-Heijnen ML, et al. Superior survival of females among 10,538 Dutch melanoma patients is independent of Breslow thickness, histologic type and tumor site. Ann Oncol 2008; 19: 583-589.
https://doi.org/10.1093/annonc/mdm498
Borkowska AM, Szumera-Ciećkiewicz A, Spałek MJ, Teterycz P, Czarnecka AM, Rutkowski P. Clinicopathological features and prognostic factors of primary acral melanomas in Caucasians. J Clin Med 2020; 9: 2996.
https://doi.org/10.3390/jcm9092996
Bian SX, Hwang L, Hwang J, Ragab O, In GK, Peng D, et al. Acral lentiginous melanoma-population, treatment, and survival using the NCDB from 2004 to 2015. Pigment Cell Melanoma Res 2021; 34: 1049-1061.
https://doi.org/10.1111/pcmr.12999
Joosse A, de Vries E, Eckel R, Nijsten T, Eggermont AM, Hölzel D, et al. Gender differences in melanoma survival: female patients have a decreased risk of metastasis. J Invest Dermatol 2011; 131: 719-726.
https://doi.org/10.1038/jid.2010.354
Bello DM, Chou JF, Panageas KS, Brady MS, Coit DG, Carvajal RD, et al. Prognosis of acral melanoma: a series of 281 patients. Ann Surg Oncol 2013; 20: 3618-3625.
https://doi.org/10.1245/s10434-013-3089-0
Teramoto Y, Keim U, Gesierich A, Schuler G, Fiedler E, Tüting T, et al. Acral lentiginous melanoma: a skin cancer with unfavourable prognostic features. A study of the German central malignant melanoma registry (CMMR) in 2050 patients. Br J Dermatol 2018; 178: 443-451.
https://doi.org/10.1111/bjd.15803
Susok L, Gambichler T. Caucasians with acral lentiginous melanoma have the same outcome as patients with stage- and limb-matched superficial spreading melanoma. J Cancer Res Clin Oncol 2022; 148: 497-502.
https://doi.org/10.1007/s00432-021-03630-6
Eriksson H, Frohm-Nilsson M, Järås J, Kanter-Lewensohn L, Kjellman P, Månsson-Brahme E, et al. Prognostic factors in localized invasive primary cutaneous malignant melanoma: results of a large population-based study. Br J Dermatol 2015; 172: 175-186.
https://doi.org/10.1111/bjd.13171
Statistical Database, Statistics Sweden. Available from: https://www.statistikdatabasen.scb.se/pxweb/sv/ssd/START__BE__BE0101__BE0101Q/UtlSvBakgGrov/table/tableViewLayout1/
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