The Epidemiologic, Clinical and Histopathological Characteristics of Cutaneous Melanoma in Southern Iran

BACKGROUND: Melanoma is currently considered the most common cutaneous malignancy and the 5th most common malignancy according to cancer statistics 2018. Annually about 91,000 patients are diagnosed with melanoma and 9,500 die in USA. Knowledge of regional epidemiological and clinical characteristics are necessary to provide appropriate preventive and treatment protocol. The aim of the current study was to determine the clinical, epidemiological and histopathological characteristics of patients with cutaneous melanoma in southern Iran. METHODS: This retrospective cross-sectional study was conducted during a 7-year period from March 2011 to April 2018 in Shahid Faghihi hospital, a tertiary healthcare and referral center for cutaneous malignancies in southern Iran affiliated with Shiraz University of Medical Sciences. We included all the patients with final diagnosis of cutaneous melanoma according to the histopathology report. Melanoma of uvea, genitalia and oral cavity were excluded. The pidemiological, clinical and histopathology information were extracted from the medical charts and were reported. RESULTS: Overall we included a total number 113 patients with final diagnosis of cutaneous melanoma. The mean age of the patients on diagnosis was 58.6 ± 12.9 (ranging from 23 to 89) years. There were 72 (63.7%) men and 41 (36.3%) women among the patients. The most common site of cutaneous melanoma was found to be the lower extremity in 62 (54.8%) followed by face in 23 (20.3%) and body in 18 (15.9%). Most (51.3%) of the patients were diagnosed in Clark’s stage grade III with invasion to the junction of the papillary and reticular dermis. About 28 (24.7%) of the patient were in stage IV (reticular dermis). Lymph node involvement was reported in 32 (28.3%) and sentinel node involvement was reported in 28 (24.7%). Lymph node dissection was perfumed 43 (38.1%) patients. The mortality rate was 28 (24.7%) in all the patients. The most common predictor of the mortality was age (p=0.001) and Clark grade (p=0.002). CONCLUSION: The incidence rate of cutaneous melanoma is increasing in our region and there is a gender discrepancy (male dominance). The most common site is lower extremity and Clark grading 3 was most common. The predictors of mortality were age and Clark grading. Appropriate preventive strategies should be applied to prevent the disease.

Keywords:

Cutaneous melanoma , Epidemiology , Clinical Characteristics , Histopathology , Mortality