Malign Melanomalý Doksan Hastanýn Klinikopatolojik Deðerlendirmesi

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 ývas 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 ývas 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.

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 hastalýksýz saðkahm süresini artýrdýðý gösterilmiþtir. Bu çalýþmada amaç, hastalarýn klinikopatolojik özelliklerinin deðerlendirilmesidir. Temmuz 1997-Aðustos 2008 tarihleri arasýnda izlenen 90 hastanýn demografik ve tümör özelliklerinin yaný sýra tedavileri retrospektif olarak deðerlendirilmiþtir. Çoðunlukla ciltte yerleþtiði için artmýþ vücut yüzey alaný (VYA) ve beden kitle indeksi (BKÝ) ile iliþkisi de araþtýrýlmýþtýr. Hastalarýn %56’sý erkek ve %44’ü kadýndý. Median yaþ 52 (19-75) olarak bulundu. En sýk komorbid hastalýðýn hipertansiyon (%28) olduðu gözlendi. Hastalarýn %41.1’inde sigara öyküsü, %15'inde ise ailede kanser öyküsü vardý. Olgularda median BKÝ 26.3 kg/m2, VYA 1.8 m2 olarak saptandý. En sýk nodüler tip (%55.3) ve alt ekstremitede yerleþim (%30) izlenmiþtir. Median "Clark düzeyi 4’’ ve “Brest!ow" tümör kalýnlýklarý 4 mm iken median çýkarýlan lenf nodu sayýsý 15 olup olgularda median lenf nodu tutulumu sayýsý 1 olarak bulundu. Adjuvan IFN oraný %48.8, bunlarýn %25’i yüksek doz-ÝFN almýþtýr. Taný anýnda metastaz oraný %21, relaps oraný %51.2 iken lokal nüksle akciðer metastazý birlikteliði %14.2 olarak bulundu. Erkek cinsiyet, beþinci dekad, sigara, BKÝ > 25 kg/m2 ve hipertansiyon birlikteliði daha riskli gibi görünmektedir.