SURGICAL TREATMENT OF MALIGNANT MELANOMA

Ermira Bexheti, Elizabeta Zhogovska Mircevska, Lazo Noveski, Igor Peev, Vladimir Ginoski, Boro Xhonov

Abstract

Introduction: Malignant melanoma is one of the smallest diseases known since the time of Hippocrates, whose incidence in the last decade is the highest. Although with a vague pathophysiology of occurrence, most studies show that in its occurrence the influence has external and internal factors. The diagnosis of this disease is done by diagnosis of the primary tumor, and the search for regional and distant metastases at the time of diagnosis of it. Melanoma therapy is still primarily surgical as a method of choice. Radical lymphadenectomy is used in metastatic melanoma in regional lymph nodes combined previously with or without biopsy of the first gland guard in the regional lymph pool. Objective: The objective of this study is to show the surgical treatment of malignant melanoma at the Clinic for Plastic and Reconstructive Surgery in Skopje in the last two years. Also, the secondary goals are to display treatment for locally localized malignant melanoma in the regional lymph nodes. Material and Methods: This is one retrospective study of treated patients from malignant melanoma at the Clinic for Plastic and Reconstructive Surgery in the period from January 2015 to August 2017, during which a total of 235 patients were analyzed. Two groups of patients with primary melanoma without signs of regional metastases (135) and melanoma with clinically present substrate in the regional lymph nodes were analyzed (100). In 40 patients, a previous biopsy of the first lymph gland was performed. Results: The applied methods in the performed surgical treatment in all patients were adequate and successfully performed. There have been no serious complications in post-operative monitoring of patients. In the 40 patients based on the thickness of the primary malignant melanoma after the pathohistological analysis, the first lymph gland biopsy was performed to determine the further course of treatment. Conclusion: This study confirmed that the surgical treatment of malignant melanoma is a golden method of choice for the treatment of this malignant disease. The study also emphasized the significance of the biopsy of the first liver gland guard, in the early identification of the presence of (micro) metastases in regional lymph nodes and the need for radical regional lymphadenectomy.

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