Clinicopathologic Analysis of Malignant Melanoma

Lee, Dong Hoon; Kim, You Chan; Cho, Sang Ho; Lee, Min Geol

Abstract

BACKGROUND: Cutaneous melanoma is the leading fatal illness arising in the skin. The clinical and pathological characteristics of malignant melanoma are quite different among races and countries.
OBJECTIVE
The purpose of this study was to investigate the clinicopathologic behavior of malignant melanoma in Korea and define prognostic predictors.
METHODS
From the 61 patients diagnosed with malignant melanoma at the Department of Dermatology of the Severance Hospital, Yonsei University College of Medicine over a 12 year period(1989-2001), we analyzed mean age at onset, gender, histologic subtypes, tumor thickness, primary tumor locations, and metastatic sites. Univariate analysis and multivariate analyses for survival, according to clinical and histologic tumor behavior, were performed by means of Cox proportional hazard model. Survival curves were plotted by Kaplan-Meier method.
RESULTS
Fifty-eight primary cutaneous melanomas were identified and analyzed by both clinical behavior and histology. 1. The incidence of malignant melanoma has been rising at a fast rate in the Department of Dermatology, Yonsei University College of Medicine. 2. The male to female ratio was 1:1. Acral lentiginous melanoma was the most common type(56.9%) followed by nodular melanoma(19.0%), superficial spreading melanoma(12.1%), lentigo maligna melanoma(6.9%), and mucosal melanoma(5.1%) in this study. ALM(59 years) and SSM(53 years) developed in elderly persons, while NM(43 years) developed in younger persons. 3. Sole and nail bed were the favored sites in ALM. Trunk was the favored site in SSM. 4. Univariate and multivariate analyses for overall survival of melanoma revealed that male gender, lentigo maligna melanoma, thicker tumor(>or=4.0mm), advanced stage(III and IV) have the tendency to poorer prognosis with significant differences.
CONCLUSION
Our study revealed acral lentiginous melanoma was the most predominant type of melanoma in Korea, which is similar result to other Asian countries'. No similar large series has been conducted to assess the prognostic factors of melanoma in Korea. Therefore, we propose that gender, histologic subtypes, tumor thickness, stages are the independent risk factors for poor prognosis. Further prospective studies are needed to assess the biologic behavior of malignant melanoma of which the incidence has been increasing in Korea.