The clinical and histopathological characteristics of cutaneous malignant melanoma

Deri malign melanomlarının en etkili tedavi yöntemi erken dönemde yapılacak cerrahi eksizyondur. Bu çalışmada malign melanomun tanımlayıcı özelliklerinin saptanması amaçlandı. Hastalar ve Yöntemler: Malign melanom saptanan 55 hastanın (32 erkek, 23 kadın; ort. yaş 50.9±12.9; dağılım 26-76) dosyaları geriye dönük olarak incelendi. Evre I ve evre II hastalara yalnızca cerrahi eksizyon yapıldı. Ameliyat öncesi dönemde palpabl lenf nodu tespit edilen evre-III ve evre-IV hastalarda cerrahi eksizyonla birlikte bölgesel lenf nodu diseksiyonu yapı ldı. Malign melanomların yerleşim yerleri, histolojik alt türleri ve evreleri gibi tanımlayıcı özellikleri incelendi; tümör çapı ve derinliği, yardımcı kemoterapi ve immünoterapi oranları, lokal yineleme oranları değerlendirildi. Bulgular: Kırk bir hastada (%74) palpabl lenf nodu tespit edildi. Bu hastalara cerrahi eksizyonla birlikte bölgesel lenf nodu diseksiyonu yapıldı. Ortalama tümör çapı 21.7±11.6 mm, tümör derinliği ise 2.1±1.3 mm bulundu. Sonuç: Cerrahi sınırların genişliği ve lenf nodu diseksiyonu ile lokal yineleme, uzak metastazlar ve yaşam süresi arasında anlamlı bir ilişki olmadığı saptandı. Bölgesel lenf nodu diseksiyonu yapmaya karar verirken diseksiyondan beklenen yararlar ve olası komplikasyonlar göz önünde bulundurularak karar verilmelidir.

Anahtar Kelimeler:

Lenf düğümü çıkartılması, Melanom, Geriyedönük çalışma, Deri neoplazmları

Malign melanomların klinik ve histopatolojik özellikleri

The most effective method of treatment of cutaneous malignant melanoma (CMM) is surgical excision performed in the early stages. Our aim was to evaluate the descriptive characteristics of CMM. Patients and Methods: Fifty-five patients with malignant melanoma (32 males, 23 females; mean age 50.9±12.9; years, range 26 to 76 years) were evaluated retrospectively. Surgical excision alone was performed on stage I and II patients. Regional lymph-node dissection was performed together with surgical excision on patients with palpabl lymph nodes (stages III and IV) detected during preoperative examination. Descriptive characteristics such as anatomical locations, histological subtypes and stages of the CMM were examined; the tumor size and thickness, adjuvant chemotherapy and immunotherapy rates, local recurrence rates were evaluated. Results: Palpabl lymph nodes were identified in 74% (n=41) of the patients. Lymph-node dissection was performed together with surgical excision on these patients. The average tumor thickness and tumor size were 2.1±1.3 mm and 21.7±11.6 mm respectively. Conclusion: Width of surgical margins and wide surgical resection with lymph-node dissection for CMM will have no effect on loco-regional recurrence, distant metastases and survival rates. The complications and benefits must be meticulously evaluated before application of lymph-node dissection.

Keywords:

Lymph Node Excision, Melanoma, Retrospective Studies, Skin Neoplasms,

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