Abstract
BACKGROUND: Previous studies have suggested that trauma may be a risk factor for the development and prognosis of acral melanoma (AM). METHODS: This population-based retrospective cohort study included patients with AM and a confirmed history of trauma who received treatment at 5 melanoma treatment centers in China. Factors associated with recurrence and survival were analyzed using univariate and multivariate Cox regression analyses. RESULTS: Totally 468 AM cases were included in this study, with 101 patients in the trauma group and 367 in the non-trauma group. The trauma group had more patients with ulceration (P = .027), mitotic rate ≥ 1 (P = .036), and Clark level IV-V (P = .009) than the non-trauma group. Among stage I-II postoperative AM patients, the median recurrence-free survival (RFS) was 33.3 months (95% CI: 18.8-47.8) and 115.6 months (95% CI: 96.3-135.0) in the trauma and non-trauma groups, respectively (P < .001). Similarly, the median overall survival (OS) was 64.6 (95% CI: 54.8-74.4) and not reached (95% CI: NR), respectively (P = .002). Comparatively, no significant differences were observed in RFS or OS between the trauma and non-trauma groups in patients with stage III and IV AM. Multifactorial analysis showed that trauma was an independent risk factor for RFS and OS only in patients with stage I-II AM patients. CONCLUSIONS: Postoperative stage I-II patients in the trauma group had significantly worse RFS and OS compared to those in the non-trauma group.