Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Doğu Karadeniz Bölgesi'ndeki Kutanöz Malign Melanom Hastalarının Tümör Kalınlığı ve Sağkalım Açısından Retrospektif Değerlendirilmesi: Kohort Çalışması
Retrospective Evaluation of Cutaneous Malignant Melanoma Patients in the Eastern Black Sea Region in Terms of Tumor Thickness and Survival: Cohort Study
Fatih AKKAYAa , Necdet URHANa , Murat LİVAOĞLUa , Şafak ERSÖZb
aKaradeniz Teknik Üniversitesi Tıp Fakültesi, Plastik, Rekonstrüktif ve Estetik Cerrahi ABD, Trabzon, Türkiye
bKaradeniz Teknik Üniversitesi Tıp Fakültesi, Patoloji ABD, Trabzon, Türkiye
Turkiye Klinikleri J Med Sci. 2023;43(2):178-84
doi: 10.5336/medsci.2022-95110
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışmamızın amacı, gerek coğrafi gerekse fiziki anlamda ülkemizin diğer bölgelerinden daha farklı bir görünüme sahip olan Doğu Karadeniz Bölgesi'nin malign melanom hasta profilinin araştırılması ve bu hastaların sağkalım surelerinin Breslow kal ̈ ınlığı ile olan ilişkisinin ortaya konulmasıdır. Gereç ve Yöntemler: Çalışmamız klinik bir çalışma olup, retrospektif kohort çalışmasıdır. 2007-2018 yılları arasında Karadeniz Teknik Üniversitesi Farabi Hastanesi Plastik, Rekonstrüktif ve Estetik Cerrahi Ana Bilim Dalında malign melanom Hastalıkların Uluslararası Sınıflaması [International Classification of Diseases (ICD)] tanısı almış olan 122 hasta çalışmamıza dâhil edilmiştir. Malign melanom ICD tanısı almış, ancak kutanöz malign melanom olmayan uveal melanom, primeri bilinmeyen metastatik melanom ve mukozal melanomlar çalışmaya dâhil edilmemiştir. Ayrıca malign melanoma in situ vakaları ve eksik verilere sahip olan vakalar da çalışmaya dâhil edilmemiştir. Sağkalım hesaplamalarında 5 yıllık takibi yapılmış 81 hasta değerlendirilmiş ve istatistiksel analiz SPSS programı ile yapılmıştır. Bulgular: Malign melanom tanısı konulan kitlelerin en sık lokalizasyonu alt ekstremite (n=58, %47,5) olarak saptanmıştır. En sık tespit edilen subtip noduler malign melanom (n=50, ̈ %41,0) olmuştur. Sağkalım oranları hesaplanırken, melanom dışı sebeplerden dolayı meydana gelen ölümler dâhil edilmemiştir. Takiplerde 81 hastanın 45'i (%55,6) ölmüş, 36'sı (%44,4) ise yaşıyor olarak tespit edilmiştir. Tanı sonrası 1. yıl sonunda hastaların %88'i, 2. yıl sonunda %75'i, 5. yıl sonunda ise %48'i hâlâ yaşamaktaydı. Beş yıl sonunda Breslow kalınlığı ≤4 mm olan hastaların %57'si hâlen yaşamaktayken, >4 mm olan hastaların ise %39'u hâlen yaşamaktaydı. Sonuç: Yurt dışı çalışmalarından farklı olarak, ülkemizde malign melanom tanısı geç konulmaktadır. Daha iyi sağkalım oranları yakalamak amacıyla erken tanı modaliteleri geliştirilmelidir.

Anahtar Kelimeler: Melanoma; sağkalım
ABSTRACT
 Objective: The aim of our study is to investigate the malignant melanoma patient profile of the Eastern Black Sea region, which has a different appearance than other regions of our country both geographically and physically, and to reveal the relationship between the survival times of these patients and tumor thickness. Material and Methods: Our study is a clinical study and a retrospective cohort study. 122 patients who were diagnosed with malignant melanoma International Classification of Diseases (ICD) in the Department of Plastic, Reconstructive and Aesthetic Surgery of Karadeniz Tecnical University Farabi Hospital between 2007 and 2018 were included in our study. Non-cutaneous malignant melanoma, uveal melanoma, metastatic melanoma of unknown primary and mucosal melanomas diagnosed as malignant melanoma ICD were excluded from the study. In addition, malignant melanoma in situ cases and cases with incomplete data were not included in the study. In the survival calculations, 81 patients who were followed up for 5 years were evaluated and statistical analysis was made with the SPSS program. Results: The most common localization of malignant melanoma masses was lower extremity (n=58, 47.5%). The most common subtype was nodular malignant melanoma(n=50, 41.0%). When calculating survival rates, deaths from non-melanoma causes were not included. During the follow-up, 45 (55.6%) of 81 patients were found to have died and 36 (44.4%) were found to be alive. 88% of the patients were still alive at the end of the first year after diagnosis, 75% at the end of the 2nd year, and 48% at the end of the 5th year. At the end of 5 years, 57% of the patients with Breslow thickness ≤4 mm were still alive, while 39% of the patients with >4 mm were still alive. Conclusion: Unlike studies abroad, malignant melanoma in our country diagnosis is delayed. Early diagnosis modalities should be developed to achieve better survival rates.

Keywords: Melanoma; survival
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