A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

  • Gamsizkan, Mehmet (Department of Pathology, Maresal Cakmak Military Hospital) ;
  • Yilmaz, Ismail (GATA Haydarpasa Education and Research Hospital) ;
  • Buyukbabani, Nesimi (Istanbul Medical School, Istanbul University) ;
  • Demirkesen, Cuyan (Cerrahpasa Medical School, Istanbul University) ;
  • Demiriz, Murat (School of Medicine, Gulhane Military Medical Academy) ;
  • Cetin, Emel Dikicioglu (Acibadem Kadikoy Hospital) ;
  • Ince, Umit (School of Medicine, Acibadem University) ;
  • Akalin, Taner (School of Medicine, Ege University) ;
  • Demirkan, Nese Calli (School of Medicine, Pamukkale University) ;
  • Lebe, Banu (School of Medicine, Dokuz Eylul University) ;
  • Erdem, Ozlem (School of Medicine, Gazi University) ;
  • Gokoz, Ozay (School of Medicine, Hacettepe University) ;
  • Sakiz, Damlanur (Bakirkoy Dr. Sadi Konuk Education and Research Hospital) ;
  • Demireli, Peyker Temiz (School of Medicine, Celal Bayar University) ;
  • Astarci, Hesna Muzeyyen (School of Medicine, Abant Izzet Baysal University) ;
  • Adim, Saduman Balaban (School of Medicine, Uludag University) ;
  • Zemheri, Itir Ebru (Goztepe Education and Research Hospital, Medeniyet University) ;
  • Acikalin, Arbil (School of Medicine, Cukurova University) ;
  • Yaman, Banu (School of Medicine, Ege University) ;
  • Aydin, Ovgu (Cerrahpasa Medical School, Istanbul University) ;
  • Bassorgun, Cumhur Ibrahim (School of Medicine, Akdeniz University)
  • Published : 2015.01.06


Background: We defined melanoma distribution in a large series of Turkish patients and evaluated the prognostic parameters of melanomas. Materials and Methods: A total of 1574 patients' data was retrospectively collected at 18 centers in Turkey. Demographic characteristics were questioned and noted. Prognostic parametres were evaluated based on sentinel lymph node involvement. Results: Mean age was 56.7 (4-99) years. While 844 (53.6%) cases were male, 730 (46.4%) cases were female. One thousand four hundred forty-seven (92%) cases were invasive melanoma and 127 (8%) cases were in-situ melanoma. The most common histopathological form was the superficial spreading melanoma (SSM) which was found in 549 patients (37.9%). It was followed by nodular melanoma in 379 (26.2%), acral lentiginous melanoma (ALM) in 191 (13.2%) and lentigo maligna melanoma in 132 (9.1%), respectively. On univariate analysis, lymphovascular invasion (p<0.001), tumor thickness (p<0.001), histopathological subtype (p<0.001), Clark level (p=0.001), ulceration (p<0.001), ${\geq}6/mm^2$ mitosis (p=0.005), satellite formation (p=0.001) and gender (p=0.03) were found to be associated with sentinel lymph node positivity. Regression was associated with sentinel lymph node negativity (p=0.017). According to multivariate analysis, lymphovascular invasion and tumor thickness were significant independent predictive factors of SLN positivity. Patient age, tumor localization, precursor lesions, lymphocytic infiltration and neurotropism were not related with sentinel lymph node involvement. Conclusions: In this retrospective analysis, it was found that the prevalence of SSM is at a lower rate while the prevalence of ALM is at a higher rate when compared to western countries. According to Breslow index; most of the melanoma lesions' thickness were greater than 2 mm, corresponding Clark IV. Vascular invasion and tumor thickness are the most important factors for sentinel lymph node involvement.


Melanoma;skin;prognostic factors


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