Reevaluating Prognosis in Subungual Melanoma: A Comparison with Non-Subungual Acral Lentiginous Melanoma.

Publication date: Jul 09, 2025

The clinicopathological characteristics and survival outcomes of subungual melanoma remain unclear, with previous studies showing conflicting results. This study aimed to elucidate the clinicopathological features and survival outcomes of subungual melanoma and compare them with those of non-subungual acral lentiginous melanoma (ALM). A retrospective cohort study was conducted, analyzing data from ALM patients diagnosed between June 1980 and June 2024 at National Taiwan University Hospital. Among the 342 ALM patients included, 70 (20. 5%) had subungual melanoma. Compared to non-subungual melanoma, the subungual group had a higher proportion of younger patients and fewer cases presenting with advanced initial stages. The 5-year melanoma-specific survival (MSS) rate was 82. 3% for subungual melanoma versus 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 the subungual location, were significantly associated with MSS. While subungual melanoma appears to have a favorable prognosis, our findings suggest that this may primarily be attributable to confounding factors such as staging and improvements in prognosis over time. The subungual location itself may not represent an independent prognostic factor. Advancements in both novel therapies and diagnostic procedures may have contributed to the overall improvement in ALM prognosis observed after 2010 in this real-world study.

Concepts Keywords
Clinicopathological Acral
Conflicting Alm
June Clinicopathological
Melanoma Factors
Taiwan June
Lentiginous
Melanoma
Mss
Non
Outcomes
Prognosis
Staging
Subungual
Survival
Year

Semantics

Type Source Name
disease MESH Melanoma
pathway KEGG Melanoma

Original Article

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