Re-evaluating prognosis of subungual melanoma: a comparison with non-subungual acral lentiginous melanoma.
Journal
Clinical and experimental dermatology
Journal Volume
50
Journal Issue
12
Start Page
2376
End Page
2385
ISSN
1365-2230
Date Issued
2025-11-25
Author(s)
Abstract
The clinicopathological characteristics and survival outcomes of subungual melanoma remain unclear, with previous studies showing conflicting results. Objectives We aimed to elucidate the clinicopathological features and survival outcomes of subungual melanoma and compare them with those of non-subungual acral lentiginous melanoma (ALM). Methods A retrospective cohort study was conducted, analysing data from patients with ALM diagnosed between June 1980 and June 2024 at the National Taiwan University Hospital. Results Among the 342 patients with ALM included in our study, 70 (20.5%) had subungual melanoma. Compared with patients with non-subungual melanoma, the subungual group had a higher proportion of younger patients and fewer patients presenting with advanced initial stages. The 5-year melanoma-specific survival (MSS) was 82.3% for subungual melanoma vs. 65.7% for non-subungual melanoma (log-rank P = 0.02). However, multivariate analysis revealed that only traditional staging-related factors and the year of diagnosis, rather than a subungual location, were significantly associated with MSS. Conclusions While subungual melanoma appears to have a favourable prognosis, our findings suggest that this may primarily be attributable to confounding factors such as staging and improvements in prognosis over time. A subungual location itself may not represent an independent prognostic factor. Advances in treatments and diagnostic procedures may have both contributed to the overall improvement in ALM prognosis observed since 2010 in this real-world study.
SDGs
Type
journal article