{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T06:22:10Z","timestamp":1785046930656,"version":"3.55.0"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acral melanoma is rare and associated with a worse prognosis compared to cutaneous melanoma in other locations. Despite this, few studies have focused on the prognosis of acral melanoma, particularly in patients with initial clinical stage. The aim of this study was to assess the impact of clinical and histopathological characteristics on the disease\u2010free survival (DFS) of stage I\u2010II patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed 154 stage I\u2010II acral melanoma cases, all of whom underwent a review of the histopathological and clinical parameters. Patients were divided into groups based on the presence or absence of disease recurrence within 5\u2009years. We used Cox proportional regression to analyze independent risk factors and computed DFS curves using the Kaplan\u2013Meier method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Within 5\u2009years, 27.9% of patients experienced disease recurrence, with 90.4% occurring during the first 3\u2009years. Univariate and multivariate analyses did not identify any clinical parameters with a significant influence on DFS. The DFS rate at 5\u2009years was 72.7%. The median duration of disease recurrence after the initial diagnosis was 21\u2009months. However, Breslow thickness, presence of ulceration, &gt;3\u2009mitosis\/mm<jats:sup>2<\/jats:sup>, presence of tumor\u2010infiltrating lymphocytes (TIL), and perineural invasion were significantly associated with a decrease in time to first recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite the favorable prognosis of stage I\u2010II acral melanoma compared with advance stage, clinical and histopathological characteristics can impact prognosis. In addition to Breslow thickness and ulceration, attention should be paid to mitotic rate, presence of TIL, and perineural invasion to optimize follow\u2010up of acral melanoma patients diagnosed in the initial clinical stage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.16800","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T05:29:03Z","timestamp":1692682143000},"page":"1281-1288","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of clinical and histopathological characteristics on the disease\u2010free survival of stage I\u2010II acral melanoma patients"],"prefix":"10.1111","volume":"62","author":[{"given":"Raquel","family":"Borges de Barros Primo","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences Federal University of Grande Dourados  Dourados Mato Grosso do Sul 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