Acral Melanomas of the Sole May Have Worse Prognosis Compared with Other Sites of Acral Melanoma

Excerpt

Acral melanoma occurs on skin with much less direct sun exposure—the soles, palms, and nail beds—compared with the skin of sun-exposed regions where other subtypes of cutaneous melanoma occur: the head, neck, truck, and extremities. Therefore, we might expect acral melanomas to have a distinct genesis and biology that may not be as directly linked to sun damage. Indeed, while ultraviolet-induced oncogenesis is predominant in cutaneous melanoma, transcriptomic and genomic analyses of acral melanoma have in fact revealed an absence of ultraviolet-derived tumorigenesis.¹ Even though the molecular profile is unique, acral melanomas are currently assigned to the same stage categories and treated similarly to other subtypes of cutaneous melanomas. In this issue of Annals of Surgical Oncology, Wei et al.² examine and compare the clinicopathological and survival profiles across primary sites in acral melanoma. These authors describe a series of over 1000 patients with acral melanoma, one of the largest series known to date. Their overall findings can help inform clinicians who take care of patients with this disease about incidence and prognosis related to acral melanoma, including prognosis by anatomic site. …