Prognosis of Malignant Melanoma on Lower Extremity

ABSTRACT

PURPOSE: Malignant melanoma is recognized as the most serious skin cancer. We examined anatomical distribution and 5-year survival rate of each stage of malignant melanoma on lower leg. METHODS: We retrospectively analyzed the medical records of 91 patients(46 males and 45 females) with malignant melanoma on lower leg from 1985 to 2008. Age, sex, anatomical distribution and 5-year survival rates of each stage of malignant melanoma on lower leg were investigated. Also, 5-year survival rates of each stage and invasion depth of malignant melanoma on heel pad were investigated. RESULTS: On lower leg, most frequently 32 cases (35.1%) occurred on heel pad, 27 cases(29.7%) occurred on dorsum of foot, 18 cases(19.8%) in toe, and 14 cases(15.4%) on others in lower leg. We used the excision margin as 3-5cm. After wide excision, in stage III, IV, the patients underwent the immunologic / chemo-therapy. The incidences of each stage were 22 cases(24.2%) in stage I, 47(51.6%) in II, 17(18.7%) in III and 5(5.5%) in IV. The 5-year survival rates of each stage were 85%, 53.2%, 47.1% and 40%. On heel pad, the incidences of each stage were 5 cases(15.6%) in stage I, 19 cases(59.4%) in II, 7 cases(21.9%) in III and 1 case(3.1%) in IV. The 5-year survival rates of each stage were 80%, 63.2%, 42.9% and 100%, respectively. On heel pad, incidence of local recurrence was 2 and 5-year survival rate of this case was 100%. And systemic recurrence was 9 and 5-year survival rate of this case was 55.6%. CONCLUSION: The 5-year survival rate of malignant melanoma on heel pad was higher than previous study. To maintain the weight-bearing function of foot, we recommend the active reconstructive surgery for heel pad reconstruction after wide excision of heel pad malignant melanoma.