Nodular, acral, and mucosal melanomas that represent non-cumulative sun damage lesions account for more than 60% of melanomas in Asia but comprise only 4% in Caucasians. The distinct spectrum of manifestations might influence the clinical course and outcomes. Factors associated with the prognosis of high-risk resected melanomas from Indonesia have not yet been previously reported.
Demographic, clinical, pathological characteristics of 82 melanoma patients who underwent complete resection in 2014-2019 were analyzed.
Nodular melanoma (NM), mucosal melanoma (MM), and acral lentiginous melanoma (ALM) made up of 42.7% (n=35), 42.7% (n=35), and 14.2% (n=12) of cases, respectively. Most patients were diagnosed at advanced stages (76.8%, n=63 at Stage III-IV). For cutaneous melanomas, 89% (N=42) patients were found with Breslow’s tumor thickness more than 4 mm, 51% (N=24) with ulceration, 93% (N=43) with diameter more than 6 mm, 59% (N=28) with lymphovascular invasion, and 74% (N=35) with regional lymph node infiltration. In mucosal melanomas, 14.5% (N=5) were diagnosed with regional spread to lymph nodes and 77% cases (N=27) were found with regional infiltration beyond mucosa. Regional lymph node spread was associated with shorter overall survival (median survivals were 17 vs 23.4 months, Mantel-Cox test p=0.049). Patients diagnosed at T4 were also associated with poor overall survival (median survivals were 23 vs 32 months, Mantel-Cox test p=0.047).
Most melanoma patients in Indonesia were found as a higher risk for recurrence after the initial complete resection. Regional lymph node infiltration and thicker tumor (T4) were associated with poor prognosis. Early detection and advancement of treatment strategy are required to improve the survivals of melanoma patients in Indonesia.
Sumadi Lukman Anwar.
Universitas Gadjah Mada.
All authors have declared no conflicts of interest.