scholarly journals The AST/ALT (De Ritis) Ratio Predicts Survival in Patients with Oral and Oropharyngeal Cancer

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 973
Author(s):  
Olivia Knittelfelder ◽  
Daniela Delago ◽  
Gabi Jakse ◽  
Sabine Reinisch ◽  
Richard Partl ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Cell Cancer ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Independent Prognostic Factor ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Cancer Specific Survival

Aminotransaminases, including aspartate aminotransaminase (AST) and alanine aminotransaminase (ALT), are strongly involved in cancer cell metabolism and have been associated with prognosis in different types of cancer. The purpose of the present study was to evaluate the prognostic significance of the pre-treatment AST/ALT ratio in a large European cohort of patients with oral and oropharyngeal squamous cell cancer (OOSCC). Data from 515 patients treated for OOSCC at a tertiary academic center from 2000–2017 were retrospectively analyzed. Levels of AST and ALT were measured prior to the start of treatment. Uni- and multivariate Cox regression analyses were applied to evaluate the prognostic value of the AST/ALT ratio for cancer-specific survival (CSS) and overall survival (OS), survival rates were calculated. Univariate analyses showed a significant association of the AST/ALT ratio with CSS (hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.38–2.12; p < 0.001) and OS (HR 1.69, 95% CI 1.41–2.02; p < 0.001). In multivariate analysis, the AST/ALT ratio remained an independent prognostic factor for CSS and OS (HR 1.45, 95% CI 1.12–1.88, p = 0.005 and HR 1.42, 95% CI 1.14–1.77, p = 0.002). Applying receiver operating characteristics (ROC) curve analysis, the optimal cut-off level for the AST/ALT ratio was 1.44, respectively. In multivariate analysis, an AST/ALT ratio > 1.44 was an independent prognostic factor for poor CSS and OS (HR 1.64, 95% CI 1.10–2.43, p = 0.014 and HR 1.55, 95% CI 1.12–2.15; p = 0.008). We conclude that the AST/ALT ratio is a prognostic marker for survival in OOSCC patients and could contribute to a better risk stratification and improved oncological therapy decisions.

scholarly journals Prognostic Significance of Sarcopenia in Patients with Unresectable Advanced Esophageal Cancer

2019 ◽  
Vol 8 (10) ◽  
pp. 1647 ◽  
Author(s):  
Sachiyo Onishi ◽  
Masahiro Tajika ◽  
Tsutomu Tanaka ◽  
Yutaka Hirayama ◽  
Kazuo Hara ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Japanese Patients ◽  
Independent Prognostic Factor ◽  
Cancer Center ◽  
Advanced Esophageal Cancer ◽  
Cox Regression Analysis ◽  
Group 2

The prognostic significance of sarcopenia in unresectable advanced esophageal cancer remains unclear. Our study retrospectively evaluated 176 consecutive Japanese patients with esophageal squamous cell carcinoma who had been diagnosed with unresectable advanced cancer in Aichi Cancer Center Hospital between January 2007 and December 2014. Skeletal muscle mass was calculated from abdominal computed tomography (CT) scans before treatment, and patients were divided into sarcopenic and non-sarcopenic groups. Sarcopenia was present in 101 patients (57.4%). Eighty-two patients in the sarcopenic group and 63 patients in the non-sarcopenic group died during follow-up (mean: 20.3 months). The overall survival (OS) rate was significantly lower in the sarcopenic group compared to the non-sarcopenic group (2-year OS: 9.8% vs. 23.7%, p < 0.01). Cox regression analysis revealed only pretreatment sarcopenia as an independent prognostic factor (hazard ratio (HR): 1.48, 95% confidence interval (CI): 1.04–2.10, p = 0.03). In the sarcopenic group, withdrawn cases, for whom the planned treatment was discontinued for some reason, showed a significantly lower OS rate compared to complete cases (1-year OS: 11.0% vs. 59.9%, p < 0.01). The most common reason for discontinuation was aspiration pneumonia (64.5%). Presence of sarcopenia was an independent prognostic factor for unresectable advanced esophageal cancer. Identifying the presence of sarcopenia prior to treatment may improve the prognosis.

scholarly journals Expression of EEF1A1 Is Associated with Prognosis of Patients with Colon Adenocarcinoma

2019 ◽  
Vol 8 (11) ◽  
pp. 1903 ◽  
Author(s):  
Eun kyo Joung ◽  
Jiyoung Kim ◽  
Nara Yoon ◽  
Lee-so Maeng ◽  
Ji Hoon Kim ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Colon Adenocarcinoma ◽  
Independent Prognostic Factor ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Disease Free

Background: The prognostic role of the translational factor, elongation factor-1 alpha 1 (EEF1A1), in colon cancer is unclear. Objectives: The present study aimed to investigate the expression of EEF1A in tissues obtained from patients with stage II and III colon cancer and analyze its association with patient prognosis. Methods: A total of 281 patients with colon cancer who underwent curative resection were analyzed according to EEF1A1 expression. Results: The five-year overall survival in the high-EEF1A1 group was 87.7%, whereas it was 65.6% in the low-EEF1A1 expression group (hazard ratio (HR) 2.47, 95% confidence interval (CI) 1.38–4.44, p = 0.002). The five-year disease-free survival of patients with high EEF1A1 expression was 82.5%, which was longer than the rate of 55.4% observed for patients with low EEF1A1 expression (HR 2.94, 95% CI 1.72–5.04, p < 0.001). Univariate Cox regression analysis indicated that age, preoperative carcinoembryonic antigen level, adjuvant treatment, total number of metastatic lymph nodes, and EEF1A1 expression level were significant prognostic factors for death. In multivariate analysis, expression of EEF1A1 was an independent prognostic factor associated with death (HR 3.01, 95% CI 1.636–5.543, p < 0.001). EEF1A1 expression was also an independent prognostic factor for disease-free survival in multivariate analysis (HR 2.54, 95% CI 1.459–4.434, p < 0.001). Conclusions: Our study demonstrated that high expression of EEF1A1 has a favorable prognostic effect on patients with colon adenocarcinoma.

scholarly journals Fibronectin and Periostin as Prognostic Markers in Ovarian Cancer

Cells ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 149 ◽  
Author(s):  
Katarzyna Aleksandra Kujawa ◽  
Ewa Zembala-Nożyńska ◽  
Alexander Jorge Cortez ◽  
Tomasz Kujawa ◽  
Jolanta Kupryjańczyk ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Prognostic Factor ◽  
Prognostic Markers ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Advanced Ovarian Cancer ◽  
Independent Prognostic Factor ◽  
Benign Tumors ◽  
Molecular Features ◽  
Kaplan Meier

Previously, based on a DNA microarray experiment, we identified a 96-gene prognostic signature associated with the shorter survival of ovarian cancer patients. We hypothesized that some differentially expressed protein-coding genes from this signature could potentially serve as prognostic markers. The present study was aimed to validate two proteins, namely fibronectin (FN1) and periostin (POSTN), in the independent set of ovarian cancer samples. Both proteins are mainly known as extracellular matrix proteins with many important functions in physiology. However, there are also indications that they are implicated in cancer, including ovarian cancer. The expression of these proteins was immunohistochemically analyzed in 108 surgical samples of advanced ovarian cancer (majority: high-grade serous) and additionally on tissue arrays representing different stages of the progression of ovarian and fallopian tube epithelial tumors, from normal epithelia, through benign tumors, to adenocarcinomas of different stages. The correlation with clinical, pathological, and molecular features was evaluated. Kaplan–Meier survival analysis and Cox-proportional hazards models were used to estimate the correlation of the expression levels these proteins with survival. We observed that the higher expression of fibronectin in the tumor stroma was highly associated with shorter overall survival (OS) (Kaplan–Meier analysis, log-rank test p = 0.003). Periostin was also associated with shorter OS (p = 0.04). When we analyzed the combined score, calculated by adding together individual scores for stromal fibronectin and periostin expression, Cox regression demonstrated that this joint FN1&POSTN score was an independent prognostic factor for OS (HR = 2.16; 95% CI: 1.02–4.60; p = 0.044). The expression of fibronectin and periostin was also associated with the source of ovarian tumor sample: metastases showed higher expression of these proteins than primary tumor samples (χ2 test, p = 0.024 and p = 0.032). Elevated expression of fibronectin and periostin was also more common in fallopian cancers than in ovarian cancers. Our results support some previous observations that fibronectin and periostin have a prognostic significance in ovarian cancer. In addition, we propose the joint FN1&POSTN score as an independent prognostic factor for OS. Based on our results, it may also be speculated that these proteins are related to tumor progression and/or may indicate fallopian–epithelial origin of the tumor.

The lymphocyte to monocyte ratio in peripheral blood represents a novel prognostic marker in patients with pancreatic cancer

2015 ◽  
Vol 53 (3) ◽  
Author(s):  
Michael Stotz ◽  
Joanna Szkandera ◽  
Tatjana Stojakovic ◽  
Julia Seidel ◽  
Hellmut Samonigg ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Prognostic Factor ◽  
Peripheral Blood ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Independent Prognostic Factor ◽  
Lymphocyte To Monocyte Ratio

AbstractIntra-tumoral macrophages have been involved as important players in the pathogenesis and progression of cancer. Recently, inflammatory parameters of the systemic inflammatory response have also been proposed as usefully prognostic biomarkers. One of these, the lymphocyte to monocyte ratio (LMR) in peripheral blood has been shown as a prognostic factor in hematologic and some solid tumors. In this study we analyzed for the first time the prognostic value of LMR in a large middle European cohort of pancreatic cancer (PC) patients.Data from 474 consecutive patients with ductal adenocarcinoma of the pancreas were evaluated retrospectively. Cancer-specific survival (CSS) was analyzed using the Kaplan-Meier method. To further evaluate the prognostic significance of the LMR, univariate and multivariate Cox regression models were calculated.Increased LMR at diagnosis was significantly associated with well-established prognostic factors, including high tumor stage and tumor grade (p<0.05). In univariate analysis, we observed that an increased LMR was a significant factor for better CSS in PC patients (HR 0.70; 95% CI 0.57–0.85; p<0.001). In multivariate analysis including age, Karnofsky Index, tumor grade, tumor stage, administration of chemotherapy, LMR and surgical resection, we confirmed increased LMR as an independent prognostic factor for CSS (HR 0.81; 95% CI 0.66–0.99; p=0.04).In conclusion, we identified LMR as an independent prognostic factor in PC patients. Our results indicate that the LMR might represent a novel and useful marker for patient stratification in PC management.

scholarly journals Chemokine (C-X-C motif) ligand 1 is associated with tumor progression and poor prognosis in patients with colorectal cancer

2018 ◽  
Vol 38 (4) ◽  
Author(s):  
Changhua Zhuo ◽  
Xianyi Wu ◽  
Jing Li ◽  
Dan Hu ◽  
Jinliang Jian ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factor ◽  
Cancer Progression ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Independent Prognostic Factor ◽  
In Vitro Assays ◽  
Tumor Diameter ◽  
Cxcl1 Expression

Chemokine (C-X-C motif) ligand 1 (CXCL1) is a chemotactic cytokine known to regulate cancer progression and invasion. However, the prognostic significance of CXCL1 expression in colorectal cancer (CRC) has not been fully characterized. The present study explored the clinicopathological significance and potential role of CXCL1 in the carcinogenesis and progression of CRC. The protein expression of CXCL1 was measured immunohistochemically in tissue microarrays constructed from 276 CRC patients. CXCL1 expression levels and their associations with clinicopathological characteristics and patient survival were evaluated. The effect of CXCL1 on glycolysis was also examined. High CXCL1 expression was detected in 165 (59.8%) cases. CXCL1 expression was correlated with tumor diameter (P=0.002), T stage (P=0.044), N stage (P=0.005), M stage (P=0.001), lymphovascular invasion (P=0.010), and carcinoembryonic antigen status (P=0.019). High CXCL1 expression was validated as an independent prognostic factor for overall survival (OS) and disease-free survival (DFS) by both univariate and multivariate Cox regression analyses (both P<0.05). Experimentally, expression of CXCL1 was knocked down by stable transfected short hairpin RNA, resulting in a significantly decreased rate of glycolysis both in in vitro assays and in patients’ samples (P<0.05). Silencing the expression of CXCL1 decreased the levels of the glycolytic enzymes GLUT1, HK2, and LDHA. In conclusion, by inducing glycolysis, CXCL1 plays a crucial role in both cancer progression and metastasis in CRC patients. The CXCL1 expression level is an independent prognostic factor for both OS and DFS. Moreover, CXCL1 may serve as a new biomarker and potential therapeutic target for CRC treatment.

The effect of corticosteroid (Cs) use during docetaxel (D) treatment on overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16522-e16522
Author(s):  
Fruzsina Gyergyay ◽  
Barna Budai ◽  
Krisztina Biro ◽  
Zsofia Kuronya ◽  
Krisztian Nagyivanyi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Gleason Score ◽  
Cox Regression ◽  
Negative Influence ◽  
Abiraterone Acetate ◽  
Independent Prognostic Factor ◽  
Castration Resistant Prostate Cancer ◽  
Kaplan Meier

e16522 Background: Cs are commonly used in the treatment of mCRPC, because of their inhibitory effects on the secretion of ACTH and their palliative effects. Inhibition of ACTH results in downregulation of adrenal androgens. Cs may have a cytotoxic effect on prostate cancer cells, mediated in part by the downregulation of androgen receptors and the activation of glucocorticoid receptor-mediated signaling and downstream antiangiogenic activity. The rationale for adding Cs to D chemotherapy is for the management of symptoms and adverse events rather than for improving responses. D (without Cs) + ADT (androgen-deprivation therapy) vs ADT alone in castration-sensitive prostate cancer has resulted in significant increase in survival (NEJM, 2015). Cs has been reported to adversely influence OS during enzalutamide (NEJM, 2012). In the COU-AA-301 trial Cs use at baseline was an independent prognostic factor in multivariate analysis, but not in a stepwise selection model (JCO, 2013). Methods: We performed a retrospective analysis of 117 mCRPC pts treated with D. All pts had standard Cs premedication before D and 74 pts received prednisone 5 mg po BID, but 43 pts didn’t get continuous Cs therapy. Kaplan-Meier estimates and Cox regression model were used. Results: Pts characteristics were as follows: median age 66 yrs (range 48-81), Gleason score ≤6: 22pts, ≥7: 61pts. (34 NA). Altogether 1015 cycles of D were given, median 8 (range 2-27). Subsequent therapies were as follows: Abiraterone Acetate (AA) (75), Mitoxantrone (46), Xofigo (5), other chemotherapies (7), none (21). Pts receiving Cs had an inferior OS in all subgroups, although none was significant (Table). Only the Gleason score was an independent prognostic factor in multivariate analysis. Conclusions: Our data suggest, that D therapy withouth Cs is at least as effective as the combination. More data is neccesary to support the suspicion of negative influence of Cs on OS. Thus unnecesarry Cs treatment might be ommited. [Table: see text]

scholarly journals Construction of an RNA Binding Protein-based Model for Prognosis Prediction of Colorectal Cancer

2020 ◽  
Author(s):  
Ting li ◽  
Wenjia Hui ◽  
Halina Halike ◽  
Feng Gao
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factor ◽  
Risk Score ◽  
Rna Binding ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Gene Signature ◽  
Independent Prognostic Factor ◽  
Time Dependent ◽  
Incidence And Mortality

Abstract Background: Colorectalcancer (CRC) is a prevalent gastrointestinal tumor with high incidence and mortality. Dysregulation of RNA binding proteins (RBPs) has been found in a variety of cancers and is related to oncogenesis and progression. This study aimed to develop and validate new biomarkers related to CRC prognosis by a series of bioinformatics analysis.Methods: We mined the gene expression data of 510 CRC samples from The Cancer Genome Atlas (TCGA) database, differentially expressed genes were screened and prognosis-related genes were identified. Furthermore, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were carried out. A prognosis-related gene signature was constructed by univariate and multivariate Cox analysis. Kaplan–Meier curves and time-dependent receiver operating characteristic (ROC) curves were utilized to evaluate the signature,The test set was used to validate the RBPs risk score model.Survival analysis was carried out to determine the independent prognostic significance of the signature. A nomogram combined with the gene signature was constructed.Results: A total of 224 aberrantly expressed RBPs were obtained, comprising 78 downregulated and 146 upregulatedRBPs. 13 RBPs with p < 0.005 were revealed in univariateCox regression analysis of train group, then stepwise multivariate Cox regression was applied for constituting an eight- RBP (BRCA1, TERT, TDRD7, PPARGC1A, LUZP4, CELF4, ZC3H12C, PNLDC1) signature prognostic biomarkers. Further analysis demonstrated that high risk score for patients was significantly related to poor overall survival according to the model. The area under the time-dependent receiver operator characteristic curve of the prognostic model was 0.730 at 5 years. The signature-based risk score was an independent prognostic factor in CRC patients. We also established a nomogram based on eight RBPs and internal validation in the train set, which displayed a favorable discriminating ability for Colorectal cancer.Conclusions: The established eight-RBP signature may serve as a novel independent prognostic factor that could be an important tool to predict the prognostic outcome of CRC patients. However, the specific biological mechanism needs further verification.

Prognostic value and optimal cut off of neutrophil/lymphocyte ratio (NLR) in patients with metastatic renal cell cancer (mRCC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16059-e16059
Author(s):  
Gustavo Jankilevich ◽  
Matias Salazar ◽  
Gabriela Nacuzzi ◽  
Daniel Chirino ◽  
Luciana Gennari
Keyword(s):  
Multivariate Analysis ◽  
Cox Regression ◽  
Cell Cancer ◽  
Prognostic Significance ◽  
Community Setting ◽  
Risk Groups ◽  
Prognostic Information ◽  
Poor Overall Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

e16059 Background: Several biomarkers were tested in mRCC but only outcome scores showed prognostic significance. Neutrophil-to-lymphocyte ratio (NLR) has shown prognostic significance for OS in a number of cancer types but value and cutoff in mRCC is unknown. Methods: The aim of this study was to evaluate NLR as prognostic factor and find a cutoff in mRCC pts. The medical records of 103 pts with mRCC were reviewed. Analysis included adjusting for baseline disease and patient characteristics and investigating potential interaction effects between NLR status and significant BL predictors of outcome. Overal Survivall (OS) was estimated by the Kaplan-Meier method.Univariate and multivariate analysis was performed by Cox regression. Results: Total pts reviewed were 103, MSKCC risk groups (37% Good, 47% Intermediate,16% Poor).Median follow up were 50 months and median OS 29 months. Nephrectomy was performed in 81% of cases.Ninety six percent received treatment (tki – mTor inhibitors). The optimal cutoff was 4, pts with NLR ≤4 vs ≥4 have higher OS 32m vs 10m HR 3,38 (IC95%: 2,60- 4,50 p:0,0001) univariate and HR: 4,32 (IC 95%: 3,35-5,4 p:0,003) in the multivariate analysis. Conclusions: Our series show MSKCC score and RLN were prognostic factors in univariable and multivariable analisys. NRL ≥ 4 identify a group of patients with poor overall survival. The NLR provides independent prognostic information for patients with mRCC and could be useful in academic and community setting. [Table: see text]

scholarly journals Systemic Immune-Inflammation Index as a Prognostic Marker of Late Recurrence in Operable Gastric Cancer: A Dual Center Study

2021 ◽  
Author(s):  
Emre Yekedüz ◽  
İzzet Doğan ◽  
Dılşa Mızrak Kaya ◽  
İlker Özgür ◽  
Güngör Utkan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Late Recurrence ◽  
Independent Prognostic Factor ◽  
Operating Characteristics ◽  
Cox Regression Analysis ◽  
Immune Inflammation ◽  
Recurrence Group

Abstract Aim To evaluate the prognostic role of the systemic immune-inflammation index (SII) in patients with operable gastric cancer. Methods We assessed 354 patients with operable gastric cancer from tertiary centers in Turkey. SII was calculated by following formula: [neutrophil (cellsx109/L) x platelet (cellsx109/L)] / lymphocyte (cellsx109/L). The best cut-off value for SII was determined by using “receiver operating characteristics (ROC)” analysis. We used log-rank and Cox-regression analysis for survival analyses. Results One hundred twenty patients were in the late recurrence group (recurrences have developed 36 months after the surgery). SII was not a prognostic factor in the early recurrence group. However, relapse-free survival (RFS) was longer in SII-low patients than SII-high patients in the late recurrence group. In multivariable analysis, SII was the only independent prognostic factor for RFS in the late recurrence group (Hazard Ratio (HR): 5.42, 95% CI:1.18-24.82, p=0.03). Conclusion SII was an independent prognostic factor for RFS in GC patients with late recurrence. Late recurrence risk was higher in SII-high patients than SII-low patients. Inflammation contributes to tumor progression, invasion, and metastasis. Prolonged exposure to chronic inflammation could explain the results of this study.

scholarly journals Prognostic Significance of Subungual Anatomic Site in Acral Lentiginous Melanoma

2020 ◽  
Author(s):  
Haider A. Mejbel ◽  
Carlos A. Torres-Cabala ◽  
Denái R. Milton ◽  
Doina Ivan ◽  
Priyadharsini Nagarajan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Survival Rates ◽  
Prognostic Significance ◽  
Independent Prognostic Factor ◽  
Disease Specific Survival ◽  
Anatomic Site ◽  
Acral Lentiginous Melanoma ◽  
The Impact ◽  
Disease Specific

Context.— Acral lentiginous melanoma is a rare and aggressive type of cutaneous melanoma that arises on the acral skin and the nail unit. The prognostic significance of subungual anatomic site in acral lentiginous melanoma is not established. Objective.— To assess the impact of subungual anatomic site on overall survival and disease-specific survival in acral lentiginous melanoma. Design.— Retrospective cohort analysis. Clinicopathologic characteristics of 627 primary acral lentiginous melanomas (45 [7%] subungual and 582 [93%] nonsubungual) were summarized, and the impact of these characteristics on overall survival and disease-specific survival was determined using univariate and multivariable analyses. Results.— No significant differences in clinicopathologic features were identified between the subungual and nonsubungual acral lentiginous melanomas. The 1-, 5-, and 10-year overall survival rates were 81%, 40%, and 28%, respectively, for subungual acral lentiginous melanoma and 94%, 59%, and 38%, respectively, for nonsubungual acral lentiginous melanoma (P = .04); risk of death was significantly higher for subungual tumors (hazard ratio [95% confidence interval] = 1.59 [1.02–2.50]; P = .04). The 1-, 5-, and 10-year disease-specific survival rates were 94%, 56%, and 48%, respectively, for subungual acral lentiginous melanoma versus 96%, 69%, and 55%, respectively, for nonsubungual acral lentiginous melanoma (P = .18). By multivariable analysis, independent poor prognostic factors included older age and ulceration for overall survival and greater Breslow thickness and sentinel lymph node positivity for overall survival and disease-specific survival. Subungual anatomic site was not an independent prognostic factor for overall or disease-specific survival. Conclusions.— Subungual anatomic site is not an independent prognostic factor for acral lentiginous melanoma.

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