Özlem DOĞAN, Yakup DUZKOPRU, Hayriye ŞAHİNLİ

Kutanöz Malign Melanom Nedeniyle Takip Ettiğimiz Hastaların Klinikopatolojik Özellikleri

ÖZ Amaç: Bu çalışmada, merkezimizde kutanöz malign melanom tanısı alan hastaların demografik özelliklerini, aldıkları tedavileri ve yanıtlarını incelemeyi amaçladık. Gereç ve Yöntemler: Temmuz 2012- Haziran 2022 arasında onkoloji kliniğimizde malign melanom tanısı alan 45 hasta retrospektif olarak taranarak toplam 32 hasta çalışmaya dahil edildi. Klinik ve demografik veriler deskriptif analizlerle sunuldu. Kategorik ve numerik değişkenler sayı ve yüzde olarak verildi(n,%). PFS ve OS Kaplan-Meier metoduyla hesaplandı. Bulgular: Çalışmaya dahil edilen hastaların 19’u(%59.4) erkek, 13’ü kadın(%40.6) idi. Hastaların median yaşı 65 (38-86) idi. Primer tümör sırasıyla 13(%40.6) hastada extremitede, 6(%18.8) hastada gövdede ve 13(% 40.6) hastada baş-boyunda yerleşimli idi. 8(%25) hastada BRAF mutasyonu mevcuttu. Hastaların 22(%68.7)’si metastatik evrede idi. Metastatik evredeki hastalarda progresyonsuz sağkalım(PFS) 5.2 ay (std. err:1.21, %95CI:2.86-7.59) iken, median genel sağkalım(OS) 23.9 (std. err:3.65, %95CI:16.8-31.11) ay idi. Sonuç: Sonuç olarak kutanöz malign melanom en sık görülen beşinci kanserdir. İleri evrede mortalite oranları çok yüksektir ve multidisipliner takip gerekmektedir.

Anahtar Kelimeler:

Kutanöz;, Malign;, Melanom

Keywords:

Kutanöz; Malign; Melanom, Kutanöz; Malign; Melanom Kutanöz;, Malign;, Melanom,

PDF

___

1. R. M. Slominski, M. A. Zmijewski, and A. T. Slominski, "The role of melanin pigment in melanoma," Experimental dermatology, vol. 24, no. 4, p. 258, 2015.
2. A. J. Miller and M. C. Mihm Jr, "Melanoma," New England Journal of Medicine, vol. 355, no. 1, pp. 51-65, 2006.
3. J. F. Thompson, R. A. Scolyer, and R. F. Kefford, "Cutaneous melanoma," The Lancet, vol. 365, no. 9460, pp. 687-701, 2005.
4. W. W. Dzwierzynski, "Managing malignant melanoma," Plastic and reconstructive surgery, vol. 132, no. 3, pp. 446e-460e, 2013.
5. R. L. Siegel, K. D. Miller, and A. Jemal, "Cancer statistics, 2019," CA: a cancer journal for clinicians, vol. 69, no. 1, pp. 7-34, 2019.
6. A. Jemal et al., "Recent trends in cutaneous melanoma incidence and death rates in the United States, 1992-2006," Journal of the American Academy of Dermatology, vol. 65, no. 5, pp. S17. e1-S17. e11, 2011.
7. R. D. Evans et al., "Risk factors for the development of malignant melanoma—I: Review of case‐control studies," The Journal of dermatologic surgery and oncology, vol. 14, no. 4, pp. 393-408, 1988.
8. G. B. Ivry, C. A. Ogle, and E. K. Shim, "Role of sun exposure in melanoma," Dermatologic surgery, vol. 32, no. 4, pp. 481-492, 2006.
9. D. Gordon et al., "Time trends in incidence of cutaneous melanoma by detailed anatomical location and patterns of ultraviolet radiation exposure: a retrospective population-based study," Melanoma research, vol. 25, no. 4, pp. 348-356, 2015.
10. N. Klebanov, M. Artomov, W. B. Goggins, E. Daly, M. J. Daly, and H. Tsao, "Burden of unique and low prevalence somatic mutations correlates with cancer survival," Scientific reports, vol. 9, no. 1, pp. 1-7, 2019.
11. P. A. Ascierto et al., "The role of BRAF V600 mutation in melanoma," Journal of translational medicine, vol. 10, no. 1, pp. 1-9, 2012. TJCL Volume 14 Number 1 p: 7-11 11
12. J. A. Curtin et al., "Distinct sets of genetic alterations in melanoma," New England Journal of Medicine, vol. 353, no. 20, pp. 2135-2147, 2005.
13. W. H. Chappell et al., "Ras/Raf/MEK/ERK and PI3K/PTEN/Akt/mTOR inhibitors: rationale and importance to inhibiting these pathways in human health," Oncotarget, vol. 2, no. 3, p. 135, 2011.
14. R. L. Siegel, K. D. Miller, and A. Jemal, "Cancer statistics, 2015," CA: a cancer journal for clinicians, vol. 65, no. 1, pp. 5-29, 2015.
15. C. M. Balch et al., "Final version of 2009 AJCC melanoma staging and classification," Journal of clinical oncology, vol. 27, no. 36, p. 6199, 2009.
16. J. Geller, S. M. Swetter, J. Leyson, D. R. Miller, K. Brooks, and A. C. Geller, "Crafting a melanoma educational campaign to reach middle-aged and older men," Journal of cutaneous medicine and surgery, vol. 10, no. 6, pp. 259-268, 2006.
17. E. M. Ward et al., "Annual report to the nation on the status of cancer, featuring cancer in men and women age 20–49 years," JNCI: Journal of the National Cancer Institute, vol. 111, no. 12, pp. 1279-1297, 2019.
18. T.-A. Yuan, Y. Lu, K. Edwards, J. Jakowatz, F. L. Meyskens, and F. Liu-Smith, "Race-, age-, and anatomic site-specific gender differences in cutaneous melanoma suggest differential mechanisms of early-and late-onset melanoma," International journal of environmental research and public health, vol. 16, no. 6, p. 908, 2019.
19. A. Breslow, "Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma," Annals of surgery, vol. 172, no. 5, p. 902, 1970.
20. [J. E. Gershenwald et al., "Melanoma staging: evidence‐based changes in the American Joint Committee on Cancer eighth edition cancer staging manual," CA: a cancer journal for clinicians, vol. 67, no. 6, pp. 472-492, 2017.
21. G. S. Rogers et al., "Effect of anatomical location on prognosis in patients with clinical stage I melanoma," Archives of dermatology, vol. 119, no. 8, pp. 644-649, 1983.
22. H. Shaw, V. McGovern, G. Milton, G. Farago, and W. McCarthy, "Malignant melanoma: influence of site of lesion and age of patient in the female superiority in survival," Cancer, vol. 46, no. 12, pp. 2731-2735, 1980.
23. C. L. Day Jr et al., "Prognostic factors for melanoma patients with lesions 0.76-1.69 mm in thickness. An appraisal of" thin" level IV lesions," Annals of surgery, vol. 195, no. 1, p. 30, 1982.
24. M. Thörn, H.-O. Adami, U. Ringborg, R. Bergström, and U. Krusemo, "The association between anatomic site and survival in malignant melanoma. An analysis of 12,353 cases from the Swedish Cancer Registry," European Journal of Cancer and Clinical Oncology, vol. 25, no. 3, pp. 483-491, 1989.
25. S. Soong, "A computerized mathematical model and scoring system for predicting outcome in melanoma patients," Curaneous Melanoma, pp. 200-212, 1985.
26. K. T. Flaherty et al., "Inhibition of mutated, activated BRAF in metastatic melanoma," New England Journal of Medicine, vol. 363, no. 9, pp. 809-819, 2010.
27. J. J. Luke, K. T. Flaherty, A. Ribas, and G. V. Long, "Targeted agents and immunotherapies: optimizing outcomes in melanoma," Nature reviews Clinical oncology, vol. 14, no. 8, pp. 463-482, 2017.
28. A. Hauschild et al., "Dabrafenib in BRAF-mutated metastatic melanoma: a multicentre, open-label, phase 3 randomised controlled trial," The Lancet, vol. 380, no. 9839, pp. 358-365, 2012.
29. G. V. Long et al., "Dabrafenib and trametinib versus dabrafenib and placebo for Val600 BRAF-mutant melanoma: a multicentre, double-blind, phase 3 randomised controlled trial," The Lancet, vol. 386, no. 9992, pp. 444-451, 2015.
30. A. Ribas and J. D. Wolchok, "Cancer immunotherapy using checkpoint blockade," Science, vol. 359, no. 6382, pp. 1350-1355, 2018.
31. J. Larkin et al., "Combined nivolumab and ipilimumab or monotherapy in untreated melanoma," New England journal of medicine, vol. 373, no. 1, pp. 23-34, 2015.
32. R. Dummer et al., "Encorafenib plus binimetinib versus vemurafenib or encorafenib in patients with BRAF-mutant melanoma (COLUMBUS): a multicentre, open-label, randomised phase 3 trial," The Lancet Oncology, vol. 19, no. 5, pp. 603-615, 2018.