Subungual Melanoma
In the current study, there were analyzed 445 patients with skin melanoma of the upper and lower limbs, who were treated during 1986-2015 at the N.N. Petrov Research Institute of Oncology. Among them, 40 patients after radical surgery were selected with morphologically confirmed diagnosis subungual melanoma (SM). Significant duration of anamnesis (mainly, one - three years), location of melanoma mainly on the fingers of lower limbs (75.5%), preferentially affecting nail bone of big toe (72.5%), acral-lentiginous type of melanoma (65%), Clark Level IV invasion (57.5%), and average Breslow thickness = 5.5 mm were the most important clinical and morphological features of SM. Relative percentage of patients with stage II and III SM was 55 (n = 22) and 22.5% (n = 9), respectively, whereas with stage I - 20 (n = 8) and IV - 2.5% (n = 1). Based on the data obtained it was concluded that operation of choice for patients with SM is amputation at the middle third of the middle phalanx. It turned out that therapeutic results were rather low: 5-year survival was - 47%, 10-year survival - 20%. Compared to patients with skin melanoma of the upper and lower limbs, patients with SM have the poorest prognosis (p = 0.0001).