Amelanotic melanoma lacks melanin and is more challenging to diagnose than pigmented melanoma, often leading to delayed detection and worse outcomes. We conducted a retrospective cohort study of 322 patients (28 with amelanotic melanoma and 294 with melanotic melanoma) treated at Sheba Medical Center between 2017 and 2023. Clinical features, treatment modalities, and 1-year outcomes were analyzed. Tumor stage at diagnosis was the strongest predictor of remission, disease progression, and mortality in both groups. Pigmentation was associated with a higher likelihood of treatment modification (p = 0.02) and showed a borderline association with progression (p = 0.08). Subgroup analysis by stage revealed no significant outcome differences except for increased therapy change in stage 2 melanotic melanoma. The findings reinforce the importance of early detection, especially in amelanotic melanoma.
Aviv et al. (Fri,) studied this question.