Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Although melanoma is less common than other types of malignant skin tumors, including basal and squamous cell cancers, it accounts for about 75% of all skin cancer deaths. Melanoma is much more likely to metastasize to other parts of the body, which is not the case with other types of skin tumors. Metastatic spread is very common, particularly in advanced tumors of higher Clark and Breslow stage. The aim of the study was to analyze the prevalence and distribution of metastatic melanomas among biopsy specimens collected during the 1995-2000 period, and their relationship with primary melanoma, especially regarding Clark and Breslow staging. Metastatic melanomas were found in 210 of 75,390 (0.3%) surgical biopsies. There were 24 patients with 57 metastatic melanoma biopsies related to primary melanoma diagnosed at our hospital during the period of observation. The remaining 153 metastatic melanomas diagnosed at other hospitals or before the period of observation were not included in the study. Metastatic melanomas were more common in male patients (13 male and 11 female), age range 16-91 (mean age 53.0) years. In men, age range was 16-75, and in women 23-91 years. Metastatic melanomas occurred 1 month to 2 years (mean 4.9 months) after the diagnosis. They affected patients with Clark III-V and Breslow III-V. Metastases were not observed in Clark I-II patients; however, two metastases were detected in patients with Breslow thickness II. Also, a statistically significant increase in the prevalence of metastatic and primary melanomas (p<0.01 both) was recorded during the period of observation.Melanom je rjeđi od ostalih vrsta malignih tumora kože, uključuje bazocelularni i planocelularni rak, ali uzrokuje oko 75% svih smrti od raka kože. Melanom ima veću vjerojatnost metastaziranja u druge dijelove tijela, što nije slučaj s drugim vrstama kožnih tumora. Metastatsko širenje je vrlo često, poglavito kod uznapredovalih tumora višega stadija po Clarku i Breslowu. Cilj ovoga ispitivanja bio je analizirati učestalost i raspodjelu metastatskih melanoma među biopsijskim uzorcima u razdoblju od 1995. do 2000. godine, te njihov odnos s primarnim melanomom, poglavito u smislu Clarkove i Breslowljeve klasifikacije prema stadijima bolesti. Metastatski melanomi nađeni su u 210 od 75.390 (0,3%) kirurških biopsija. U razdoblju od 1995. do 2000. godine u našoj su Bolnici dijagnosticirana 24 bolesnika s 57 biopsija metastatskih melanoma povezanih s primarnim melanomom. Preostala 153 metastatska melanoma koji su dijagnosticirani u drugim bolnicama ili prije razdoblja promatranja nisu uključeni u ovo ispitivanje. Metastatski melanomi bili su češći u muških negoli u ženskih bolesnika (13 muških i 11 ženskih) u dobi od 16 do 91 godine (srednja dob 53,0 godine). U muških se bolesnika dobni raspon kretao od 16 do 75 godina, a u ženskih od 23 do 91 godine. Metastatski melanomi su se pojavili 1 mjesec do 2 godine nakon dijagnoze (srednja vrijednost 4,9 mjeseci). Metastatski melanom zahvatio je bolesnike sa stadijem III. - V. prema Clarku te III. - V. prema Breslowu. Metastaze nisu zabilježene u bolesnika sa stadijem I. - II. prema Clarku, međutim, dvije su metastaze nastale u bolesnika s debljinom II. stupnja prema Breslowu. U ispitivanom razdoblju opažen je i statistički značajan porast učestalosti metastatskih i primarnih melanoma (p<0,01 oboje)
