Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Global patterns in the incidence of acral melanoma: systematic review and meta-analysis (#198)

Kenneth Cho 1 2 3 , Anne Cust 1 4 , Yun Megan Foo 2 , Guy Eslick 1
  1. University of Sydney, Sydney, NSW, Australia
  2. Western Sydney University, Campbelltown, NSW, Australia
  3. University of New South Wales, Kensington, NSW, Australia
  4. Melanoma Institute Australia, Wollstonecraft, NSW, Australia

Aim

Although most cutaneous melanomas occur on sun-exposed skin, melanomas can also arise on sun-shielded skin including the palms, soles and subungual areas. These are categorized by their anatomical location as acral melanoma (AM). The global incidence of CM has increased considerably in recent decades, however little is known about the global incidence of AM. A meta-analysis was performed to explore the global incidence of AM, in particular examining the location of AM in the palms, soles and nails.

Methods

A systematic review was carried out using five electronic databases from their inception to June 2019, identifying all studies that reported the incidence of AM. Data were independently extracted by two investigators. Study quality was assessed using the appraisal tool for Cross-Sectional Studies (AXIS), the Joanna Briggs Institute (JBI) 2017 Critical Appraisal Checklist for Case Series, and the Newcastle-Ottawa Scale for the case control and cohort studies. We used a Random-effects model for data analysis based on event rates (ER) and 95% confidence interval (CI).

Results

From the 165 studies included, the results of 2,668,701 patients with melanoma were analyzed. AM was more likely to affect females ER: 53% (95% CI 49%-56%, I2 = 56.95% p = 0.14), and more often present on the soles ER: 73% (95% CI 66%-78%, I2 = 76.47% p < 0.001) compared to the palms ER: 5% (95% CI 4%-7%, I2 = 0.00% p < 0.001), lower nails ER: 20% (95% CI 15%-28%, I2 = 87.92% p < 0.001) and upper nails ER: 24% (95% CI 16%-35%, I2 = 93.30% p < 0.001). During the presentation association between ethnicity and geography with AM will also be explored.

Conclusions

AM affected the soles of the feet more often than any other location.