Saaiq Muhammad, Siddiqui Saad
Department of Plastic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan.
World J Plast Surg. 2020 Sep;9(3):296-301. doi: 10.29252/wjps.9.3.296.
Cutaneous melanomas (CMs) account for only a small proportion of skin cancers, however these are responsible for most skin cancer deaths. There has been a consistently increasing trend in their incidence across the globe.
This prospective case series study spanned over a period of three years. All patients with histologically confirmed CMs were included.
There were 31 patients including 28 males and 3 females with the mean age of 58.25±11.33 years. The histological subtypes included 13 cases (41.93%) of nodular melanoma (NM), 11 patients (35.5%) of acral lentiginous melanoma (ALM), 3 cases (9.67%) of superficial spreading melanoma (SSM) and lentigo maligna melanoma (LMM) and one case (3.22%) of desmoplastic melanoma. Two patients (6.45%) presented with stage II, whereas 21 patients had (67.74%) stage III melanoma. There were 8 patients (25.80%) with stage IV. Time interval between onset of the lesion and first presentation to hospital ranged from 6 to 17 weeks with a mean of 12.45±3.2 weeks. The overall median survival for patients with stage III and IV was 8.75 months. The overall survival for stage II at one year was 100%.
CMs more frequently affected males aged ≥58 years. Feet, face, trunk, hands and scalp were the affected anatomical body parts in decreasing order of frequency. NM and ALM were the more common histological subtypes. Majority of patients presented late and advanced stages of melanoma. Awareness about the sinister course of the disease will ensure early presentation with better treatment outcome.
皮肤黑色素瘤(CMs)仅占皮肤癌的一小部分,但却是大多数皮肤癌死亡的原因。全球范围内其发病率一直呈上升趋势。
这项前瞻性病例系列研究历时三年。纳入所有经组织学确诊为CMs的患者。
共有31例患者,其中男性28例,女性3例,平均年龄58.25±11.33岁。组织学亚型包括13例(41.93%)结节性黑色素瘤(NM)、11例(35.5%)肢端雀斑样痣黑色素瘤(ALM)、3例(9.67%)浅表扩散性黑色素瘤(SSM)和恶性雀斑样痣黑色素瘤(LMM)以及1例(3.22%)促纤维增生性黑色素瘤。2例(6.45%)患者为II期,而21例(67.74%)为III期黑色素瘤。有8例(25.80%)为IV期。病变出现至首次就诊的时间间隔为6至17周,平均为12.45±3.2周。III期和IV期患者的总体中位生存期为8.75个月。II期患者1年的总生存率为100%。
CMs更常见于年龄≥58岁的男性。足部、面部、躯干、手部和头皮是受影响的身体部位,频率依次降低。NM和ALM是更常见的组织学亚型。大多数患者就诊时已处于黑色素瘤的晚期。提高对该疾病凶险病程的认识将确保早期就诊,从而获得更好的治疗效果。