![]() ![]() To further elucidate the prognostic value of Ki67 on MSS, we conducted univariate and multivariate Cox proportional hazards regression analyses (Table 2). Of all patients, 87.6% (275/314) received complete resection and 68.8% (216/314) received interferon adjuvant therapy. Elevated LDH levels were confirmed in 11.5% (36/314) patients. Hotspot mutational analysis was performed in 233 patients, and 11.1% (35/314) of patients were detected with the BRAF mutation, 4.8% (15/314) with the c-KIT mutation, and 12.1% (38/314) with the NRAS mutation. The primary sites of all patients were soles (72.0%), nailbed (20.1%) and palm (8.0%), and the distribution was similar between patients with Ki67 ≥ 30% and Ki67 < 30% ( P = 0.546). Compared with patients with Ki67-low melanoma, the patients with Ki67-high melanoma were more likely to present with ulceration, thicker primary lesions, more lymph node metastases, distant metastasis and more advanced stages. The median age of all patients was 56.0 years. The ratio of male to female was 1.17:1 (169 vs. We summarized the characteristics of all patients based on Ki67 ≥ 30% and Ki67 < 30% in Table 1. Hence, this study aimed to summarize the clinicopathological and survival features across different Ki67 levels in AM patients and generate a predictive model to predict the survival of patients with AM.īetween January 2006 and December 2018, a total of 314 AM patients were finally enrolled in this study. However, to the best of our knowledge, there are no additional studies confirming the predictive value of Ki67 in AM and no prognostic models have been previously established based on Ki67 expression for AM. summarized and analyzed the characteristics and prognostic factors of 211 AM patients in China, and the results showed that Ki67 index in a continuous format was independently associated with prognosis (Wang et al. However, the results of studies have not been consistent. In melanoma, Ki67 expression has been proposed as a biomarker of metastasis and predictor of prognosis (Gimotty et al. Many studies have demonstrated that high Ki67 expression (with a cut-off value of 30% for the percentage of Ki67-expressing cells) is associated with poor prognosis and can predict anti-tumor therapy efficacy in breast cancer (Kurebayashi et al. It has been extensively evaluated in various malignant tumor types, especially in breast cancer. The Ki67 protein is an indicator of proliferative activity expressed in all phases of the cell cycle except G0. Therefore, it is crucial to identify additional prognostic predictors and construct new predictive models for AM. The American Joint Committee on Cancer (AJCC) staging system for tumor-node-metastasis (TNM) remains the primary tool for prognostic prediction, but it has limitations because patients at the same stage can have vastly different survival outcomes (Gershenwald et al. ![]() 2020), but subungual melanoma was considered to have worse survival than palm or sole melanoma in a previous study in Japan (Nakamura et al. discovered that sole melanoma had worse survival compared with other subtypes (Wei et al. For patients with Breslow thickness ≤ 1 mm, ulceration was significantly associated with prognosis, while for patients with Breslow thickness > 1 mm, no correlation was found (Wei et al. Interestingly, ulceration was found to have varying impact on prognosis across Breslow thickness. An analysis of 853 AM patients in China depicted the prognostic value of Breslow thickness in AM, but no association was found between tumor thickness and survival in patients with Breslow thickness > 2 mm (Wei et al. However, these results are controversial for some variables. Many risk factors, including age, Breslow thickness, ulceration status, stage, primary site, distant metastasis and lactate dehydrogenase (LDH) level have been shown to be correlated with prognosis in AM patients (Teramoto et al. While immunotherapies and target therapies have significantly improved the survival of patients with cutaneous melanoma, these therapies are less effective or are ineffective for most patients with AM. Genomically, AM shows lower mutational burdens, different oncogenic drivers and a higher number of structural chromosomal changes (Chen et al. Compared with cutaneous melanoma from other sites, AM is associated with worse prognosis and poorer survival because of delayed diagnosis (Carrera and Puig-Butille 2018 Desai et al. However, it is the most common subtype in Asian, African and Hispanic populations, constituting up to 40–75% of color populations (Chen et al. Acral melanoma (AM), arising on the non-hair-bearing skin of the palms, soles or subungual regions, is a rare melanoma type in Western populations (Markovic et al. ![]()
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