Mutlu DOĞAN, Ülkü YALÇINTAŞ ARSLAN, Saadet TOKLUOĞLU, Güze ÖZAL, Hande SELVİ, Güngör UTKAN, Hakan AKBULUT, Bülent YALÇIN, Necati ALKIŞ, Fikri İÇLİ

Clinicopathological Characteristics of Ninety MaHgnant Melanoma Patients

Malign melanoma metastaz potansiyeli yüksek otan bir malignitedir. Primer tedavisi erken evrede cerrahi olup yüksek riskli rezeke olgularda, özellikle lenf nodu tutulumu olanlarda, adjuvan yüksek doz interferon (IFN)'un hastalıksız sağkahm süresini artırdığı gösterilmiştir. Bu çalışmada amaç, hastaların klinikopatolojik özelliklerinin değerlendirilmesidir. Temmuz 1997-Ağustos 2008 tarihleri arasında izlenen 90 hastanın demografik ve tümör özelliklerinin yanı sıra tedavileri retrospektif olarak değerlendirilmiştir. Çoğunlukla ciltte yerleştiği için artmış vücut yüzey alanı (VYA) ve beden kitle indeksi (BKİ) ile ilişkisi de araştırılmıştır. Hastaların %56'sı erkek ve %44'ü kadındı. Median yaş 52 (19-75) olarak bulundu. En sık komorbid hastalığın hipertansiyon (%28) olduğu gözlendi. Hastaların %41.1'inde sigara öyküsü, %15'inde ise ailede kanser öyküsü vardı. Olgularda median BKİ 26.3 kg/m2, VYA 1.8 m2 olarak saptandı. En sık nodüler tip (%55.3) ve alt ekstremitede yerleşim (%30) izlenmiştir. Median "Clark düzeyi 4'' ve "Brest!ow" tümör kalınlıkları 4 mm iken median çıkarılan lenf nodu sayısı 15 olup olgularda median lenf nodu tutulumu sayısı 1 olarak bulundu. Adjuvan IFN oranı %48.8, bunların %25'i yüksek doz-İFN almıştır. Tanı anında metastaz oranı %21, relaps oranı %51.2 iken lokal nüksle akciğer metastazı birlikteliği %14.2 olarak bulundu. Erkek cinsiyet, beşinci dekad, sigara, BKİ > 25 kg/m2 ve hipertansiyon birlikteliği daha riskli gibi görünmektedir.

Anahtar Kelimeler:

Malign melanoma, interferon, yüksek doz interferon.

Malign Melanomalı Doksan Hastanın Klinikopatolojik Değerlendirmesi

MaHgnant melanoma (MM) is a malignancy with a high metastatic potential. Primary treatment modality is surgery in early stage. Adjuvant high dose interferon (IFN) has been shown to prolong disease-free survival in resected high-risk patients with nodal involvement. We evaluated clinicopathological characteristics and treatment modalities of patients with MM. Ninety patients followed-up in medical oncology clinics of two tertiary health çenter betvveen July 1997-August 2008 were enrolled. Demographical and tumor characteristics of the patients and treatment modalities are evaluated retrospectively. The associati-on betvveen MM and increased body surface area (BSA) or body mass index (BMI) were also evaluated, since MM frequently presents with skin involvement. 56% of the patients were male, 44% were female. Median age was 52 (range: 19-75 years). Hypertension (28%) was the most common comorbid disease. The smoking rate was 41.1% (median 20 pack-year) and family history for cancer was 15%. Most patients were ovenveight (median BMI was 26.3 kg/m2, median BSA ıvas 1.8 m2). Nodular MM (55.3%) and lower extremity localization (30%) were most common. Median "Clark's /eve/" was 4 and "Brestlovv" thickness was 4 mm. Median number of resected lymph nodes ıvas 15, and most patients had at least one nodal involvement. Adjuvant IFN was given 48.8% of the patients, and 25% of them had high dose-IFN treatment. While the metastasis rate at presentation was 21 %; 51.2% of the patients had relapse and 14.2%, had local retapse with iung metastasis. Patients with male gender, fifth deca-de, smoking history, BMI > 25 kg/m2 and hypertension seem to have higher risk.

Keywords:

MaHgnant melanoma, interferon, high dose interferon.,

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