Poor prognosis of early-stage acral melanoma with a history of trauma: a multicenter analysis of 468 patients.

BACKGROUND

Previous studies have suggested that trauma may be a risk factor for the development and prognosis of acral melanoma (AM).

METHODS

This population-based retrospective cohort study included patients with AM and a confirmed history of trauma who received treatment at 5 melanoma treatment centers in China. Factors associated with recurrence and survival were analyzed using univariate and multivariate Cox regression analyses.

RESULTS

Totally 468 AM cases were included in this study, with 101 patients in the trauma group and 367 in the non-trauma group. The trauma group had more patients with ulceration (P = .027), mitotic rate ≥ 1 (P = .036), and Clark level IV-V (P = .009) than the non-trauma group. Among stage I-II postoperative AM patients, the median recurrence-free survival (RFS) was 33.3 months (95% CI: 18.8-47.8) and 115.6 months (95% CI: 96.3-135.0) in the trauma and non-trauma groups, respectively (P < .001). Similarly, the median overall survival (OS) was 64.6 (95% CI: 54.8-74.4) and not reached (95% CI: NR), respectively (P = .002). Comparatively, no significant differences were observed in RFS or OS between the trauma and non-trauma groups in patients with stage III and IV AM. Multifactorial analysis showed that trauma was an independent risk factor for RFS and OS only in patients with stage I-II AM patients.

CONCLUSIONS

Postoperative stage I-II patients in the trauma group had significantly worse RFS and OS compared to those in the non-trauma group.