Sehgal R, Cheung C X, Alradadi R, Healy D A, Landers R, O'Donoghue G T
Department of Breast and Endocrine Surgery, University Hospital Waterford, Waterford, Ireland.
Ir J Med Sci. 2017 May;186(2):309-314. doi: 10.1007/s11845-016-1531-6. Epub 2016 Nov 21.
The incidence of cutaneous melanoma (CM) continues to rise in Ireland. Despite significant advances in melanoma molecular therapy, surgery remains the mainstay of treatment for CM. The University Hospital Waterford (UHW) prospectively maintained CM registry was established in 2010.
To summarize 5-year experience (2010-2015) of primary CM presenting to UHW.
Data were retrospectively obtained from a central electronic pathology and radiology repository augmented by HIPE data and theatre logs. Data collected included patient demographics and clinico-pathological characteristics, specimen number, size, anatomical location, melanoma subtype, Breslow thickness, Clark's level, ulceration, and mitosis.
592 CMs were managed in UHW during the study period. Overall, females comprised the majority of cases with mean age at presentation 60.78 ± 18.29 years. The most commonly affected anatomical location was the lower limb (26.7%) followed by the back (15.1%), upper limb (15.07%), and face (14.40%). Superficial spreading and lentigo maligna were the most common histological subtype accounting for 19.8 and 20%, respectively. Overall, the mean Breslow depth was 2.4 ± 3.7 mm with corresponding Clark's Level III. Sentinel lymph node positivity was 39/103 (37.89%) most commonly located in the axilla (53.8%) and groin (30.7%).
There has been a steady increase in the number of cutaneous melanoma presentations over the past 5-years to the South East Cancer Centre. Patients are managed best by prompt surgical excision and multidisciplinary management. Our results are in keeping with international standards and work continues in determining overall 5-year survival and recurrence rates.
爱尔兰皮肤黑色素瘤（CM）的发病率持续上升。尽管黑色素瘤分子治疗取得了重大进展，但手术仍然是CM治疗的主要手段。沃特福德大学医院（UHW）于2010年建立了前瞻性CM登记处。
总结2010年至2015年期间就诊于UHW的原发性CM的5年经验。
回顾性收集来自中央电子病理和放射学数据库的数据，并通过HIPE数据和手术记录进行补充。收集的数据包括患者人口统计学和临床病理特征、标本数量、大小、解剖位置、黑色素瘤亚型、Breslow厚度、Clark分级、溃疡和有丝分裂情况。
在研究期间，UHW共处理了592例CM。总体而言，女性病例居多，就诊时的平均年龄为60.78±18.29岁。最常受累的解剖部位是下肢（26.7%），其次是背部（15.1%）、上肢（15.07%）和面部（14.40%）。浅表扩散型和恶性雀斑痣是最常见的组织学亚型，分别占19.8%和20%。总体而言，平均Breslow深度为2.4±3.7mm，对应的Clark分级为III级。前哨淋巴结阳性率为39/103（37.89%），最常见于腋窝（53.8%）和腹股沟（30.7%）。
在过去5年中，东南部癌症中心皮肤黑色素瘤就诊病例数稳步增加。通过及时的手术切除和多学科管理能为患者提供最佳治疗。我们的结果符合国际标准，确定总体5年生存率和复发率的工作仍在继续。
