Öz
Aim: We aimed to evaluate the epidemiological and survival characteristics of patients diagnosed as melanoma in the database of Ege University Hospital between 1992-2017.
Materials and Methods: The data of 1530 patients diagnosed with melanoma enrolled at Ege University between 1992-2017, recorded by the CANREG 4 program by specially trained and certified cancer registry staff of the Ege University Cancer Control Research and Application Center, were collected. While the existence of the relationship between categorical variables was evaluated with the Chi-Square method, the numerical variables between the groups were compared with the One Way Variance Analysis and the Turkey HSD Test. While the effects of categorical variables on survival were examined by Kaplan Meier and Log Rank (Mantel-Cox) methods, Cox-Regression analysis was used for numerical variables. All Hypothesis tests were appliedat 0.05 significance level.
Results: Of the 1530 melanoma cases, 53.1% were male and 46.9% were female. The average age was 54.14 ± 16.537. Superficial spreading melanoma and lentigo malignant melanoma were the most common subtypes.11.6% of the melanoma lesions were in situ, 43.6% were localized, 6.7% were locally spread, 16.9% were regionally spread, 21.1% were advanced. The follow-up period of the patients ranged from 0 to 313 months. The mean survival time was 147.4 ± 5.3 months. The survival rate decreased with increasing age (p <0.01). The duration of survival was higher in women than in men (p< 0,001).
Conclusions: In our study, older age at diagnosis, male gender, not having in situ tumor, lymph node involvement and presence of metastasis are factors that decrease survival. Five-year survival is shorter in nodular melanoma than other histopathological subtypes. Five-year survivals were; 90% in localized disease, 52% in local spread, 56% in regional spread, 15% in advanced metastatic disease. Early diagnosis affects prognosis in cutaneous melanoma. For this reason, it is important to raise awareness of the society and ensure that patients apply earlier.
Anahtar Kelimeler
Kaynakça
- Garbe C, Bauer J. Melanoma. In: Bolognia JL, Schaffer JV, Cerroni L (eds). Dermatology. 4th ed. China: Elsevier; 2018:1989-2019.
- Carr S, Smith C, Wernberg J. Epidemiology and Risk Factors of Melanoma. Surg Clin North Am 2020;100(1):1-12.
- Elçin G, Çakır A. Malign melanom epidemiyolojisi ve risk faktörleri. Demirci U, editör. Cilt Kanserleri. 1. Baskı. Ankara: Türkiye Klinikleri; 2019:5-11.
- Garbe C, Amaral T, Peris K, et al. European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC). European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics - Update 2019. Eur J Cancer2020;126:141-58.
- Garbe C, Amaral T, Peris K, et al. European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC). European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2019. Eur J Cancer 2020;126:159-77.
- Ribero S, Glass D, Bataille V. Geneticepidemiology of melanoma. Eur J Dermatol. 2016;26(4):335-9.
- Siegel RL, Miller KD, Jemal A. Cancerstatistics, 2020. CA Cancer J Clin. 2020;70(1):7-30.
- Rastrelli M, Tropea S, Rossi CR, Alaibac M. Melanoma: epidemiology, risk factors, pathogenesis, diagnosis and classification. InVivo. 2014;28(6):1005-11.
- Wu Y, Wang Y, Wang L, Yin P, Lin Y, Zhou M. Burden of melanoma in China, 1990-2017: Findingsfromthe 2017 global burden of diseasestudy. Int J Cancerdoi: 10.1002/ijc.32764
- Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Akinyemiju TF, Al Lami FHet al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis forthe Global Burden of Disease Study. JAMA Oncol 2018;4(11):1553-68.
- Hacıkamiloğlu E, Gültekin M, Boztaş G ve ark. Türkiye Kanser İstatistikleri. Türkiye Halk sağlığı Kurumu. 2017, Ankara.
- Tas F. Age-specific incidence ratios in malignant melanoma in Turkey: melanoma in older people is increasing. ActaDermVenereol 2011;91(3):353-4.
- Hieken TJ, Glasgow AE, Enninga EAL, et al. Sex-Based Differences in Melanoma Survival in a Contemporary Patient Cohort. J WomensHealth (Larchmt)doi:10.1089/jwh.2019.7851.
- Zheng G, Chattopadhyay S, Sundquist K, et al. Association between tumor characteristics and second primary cancers with cutaneous melanoma survival: A nation wide cohort study. Pigment Cell Melanoma Res. doi: 10.1111/pcmr.12868.
- Baykal C, Atci T, Polat Ekinci A, Buyukbabani N. An update on cutaneous melanoma in Turkey: evaluation of 19-year data in a single tertiary centre and review of the literature. J EurAcadDermatolVenereol. 2017;31(2):236-40.
- Gamsizkan M, Yilmaz I, Buyukbabani N, et al. A retrospective multicenter evaluation of cutaneous melanomas in Turkey. AsianPac JCancerPrev 2014;15(23):10451-6.
- Wee E, Wolfe R, Mclean C, Kelly JW, Pan Y. The anatomic distribution of cutaneous melanoma: A detailed study of 5141 lesions. Australas J Dermatoldoi: 10.1111/ajd.13223.
- Naser N. Cutaneous melanoma: a 30-year-long epidemiological study conducted in a city in southern Brazil, from 1980-2009. An BrasDermatol 2011;86(5):932-41.
- Panda S, Dash S, Besra K, Samantaray S, Pathy PC, Rout N. Clinicopathological study of malignant melanoma in a regional cancer center. Indian J Cancer 2018;55(3):292-96.
Ege Üniversitesi Hastanesinde görülen deri melanomlarının epidemiyolojik ve genel sağ kalım özellikleri
Öz
Amaç: Bu çalışmada Ege Üniversitesi Hastanesi veri tabanındaki 1992-2017 yılları arası melanom
tanısı alan hastaların epidemiyolojik ve genel sağ kalım özelliklerinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezinin özel eğitimli
ve sertifikalı kanser kayıt elemanları tarafından CANREG-4 programı ile kaydedilen 1992-2017 yılları
arasında Ege Üniversitesinde kayıtlı 1530 melanom tanılı hastanın verileri toplanmıştır. Kategorik
değişkenler arası ilişki varlığı Ki-Kare yöntemiyle değerlendirilirken, gruplar arası nümerik değişkenler
Tek Yönlü Varyans Analizi ve Tukey HSD Testi ile karşılaştırıldı. Sağ kalım üzerine kategorik değişkenlerin
etkileri Kaplan Meier ve LogRank (Mantel-Cox) yöntemleri ile incelenirken, nümerik değişkenler için Cox-
Regresyon analizi kullanıldı. Tüm Hipotez testleri 0,05 önem seviyesinde uygulandı.
Bulgular: Bin beş yüz otuz melanom olgusunun %53,1’i erkek, %46,9’u kadındı. Yaş ortalaması
54,14±16,537’ydi. Yüzeyel yayılan melanom ve lentigo malign melanom en sık görülen alt tiplerdi.
Hastaların takip süresi 0 ile 313 ay arasında değişmekteydi. Ortalama genel sağ kalım (GSK) süresi
147,4 ± 5,3 aydı. Yaş artışı ile GSK süresi azalmaktaydı (p<0,01). Kadınlarda erkeklere göre GSK
süresi daha yüksekti (p<0,001).
Sonuçlar: Çalışmamızda tanı sırasında ileri yaş, erkek cinsiyet, tümörün in situ olmaması, lenf bezi
tutulumu ve metastaz varlığı sağ kalımı azaltan faktörlerdir. Beş yıllık GSK nodüler melanomda diğer
histopatolojik alt tiplere göre daha kısadır. Beş yıllık GSK; lokalize hastalıkta %90, lokal yayılım
durumunda %52, bölgesel yayılımda %56, ilerlemiş metastatik hastalıkta ise %15’tir. Kutanöz
melanomda erken tanı prognozu önemli ölçüde etkilemektedir. Melanomun yüksek mortalite oranı
dikkate alındığında; daha erken dönemde başvuruyu sağlamak açısından; toplumsal bilinç düzeyinin
olabildiğince arttırılması son derece önemlidir.
Anahtar Kelimeler
Kaynakça
- Garbe C, Bauer J. Melanoma. In: Bolognia JL, Schaffer JV, Cerroni L (eds). Dermatology. 4th ed. China: Elsevier; 2018:1989-2019.
- Carr S, Smith C, Wernberg J. Epidemiology and Risk Factors of Melanoma. Surg Clin North Am 2020;100(1):1-12.
- Elçin G, Çakır A. Malign melanom epidemiyolojisi ve risk faktörleri. Demirci U, editör. Cilt Kanserleri. 1. Baskı. Ankara: Türkiye Klinikleri; 2019:5-11.
- Garbe C, Amaral T, Peris K, et al. European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC). European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics - Update 2019. Eur J Cancer2020;126:141-58.
- Garbe C, Amaral T, Peris K, et al. European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC). European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2019. Eur J Cancer 2020;126:159-77.
- Ribero S, Glass D, Bataille V. Geneticepidemiology of melanoma. Eur J Dermatol. 2016;26(4):335-9.
- Siegel RL, Miller KD, Jemal A. Cancerstatistics, 2020. CA Cancer J Clin. 2020;70(1):7-30.
- Rastrelli M, Tropea S, Rossi CR, Alaibac M. Melanoma: epidemiology, risk factors, pathogenesis, diagnosis and classification. InVivo. 2014;28(6):1005-11.
- Wu Y, Wang Y, Wang L, Yin P, Lin Y, Zhou M. Burden of melanoma in China, 1990-2017: Findingsfromthe 2017 global burden of diseasestudy. Int J Cancerdoi: 10.1002/ijc.32764
- Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Akinyemiju TF, Al Lami FHet al. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis forthe Global Burden of Disease Study. JAMA Oncol 2018;4(11):1553-68.
- Hacıkamiloğlu E, Gültekin M, Boztaş G ve ark. Türkiye Kanser İstatistikleri. Türkiye Halk sağlığı Kurumu. 2017, Ankara.
- Tas F. Age-specific incidence ratios in malignant melanoma in Turkey: melanoma in older people is increasing. ActaDermVenereol 2011;91(3):353-4.
- Hieken TJ, Glasgow AE, Enninga EAL, et al. Sex-Based Differences in Melanoma Survival in a Contemporary Patient Cohort. J WomensHealth (Larchmt)doi:10.1089/jwh.2019.7851.
- Zheng G, Chattopadhyay S, Sundquist K, et al. Association between tumor characteristics and second primary cancers with cutaneous melanoma survival: A nation wide cohort study. Pigment Cell Melanoma Res. doi: 10.1111/pcmr.12868.
- Baykal C, Atci T, Polat Ekinci A, Buyukbabani N. An update on cutaneous melanoma in Turkey: evaluation of 19-year data in a single tertiary centre and review of the literature. J EurAcadDermatolVenereol. 2017;31(2):236-40.
- Gamsizkan M, Yilmaz I, Buyukbabani N, et al. A retrospective multicenter evaluation of cutaneous melanomas in Turkey. AsianPac JCancerPrev 2014;15(23):10451-6.
- Wee E, Wolfe R, Mclean C, Kelly JW, Pan Y. The anatomic distribution of cutaneous melanoma: A detailed study of 5141 lesions. Australas J Dermatoldoi: 10.1111/ajd.13223.
- Naser N. Cutaneous melanoma: a 30-year-long epidemiological study conducted in a city in southern Brazil, from 1980-2009. An BrasDermatol 2011;86(5):932-41.
- Panda S, Dash S, Besra K, Samantaray S, Pathy PC, Rout N. Clinicopathological study of malignant melanoma in a regional cancer center. Indian J Cancer 2018;55(3):292-96.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 26 Ekim 2020 |
| Gönderilme Tarihi | 28 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2020Cilt: 59 Özel Sayı: 1 (Onkoloji) |
