Análise do perfil epidemiológico, clínico, patológico e terepêutico de pacientes portadores de neoplasia de pele melanoma
Tipo
TCC
Data de publicação
2023-11-27
Periódico
Citações (Scopus)
Autores
Michalawiski, Letícia Midori
Miyawaki, Luana Naomi
Miyawaki, Luana Naomi
Orientador
Campos, Eurico Cleto Ribeiro de
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Resumo
O melanoma cutâneo é a neoplasia maligna dos melanócitos , que representa cerca de 4% das neoplasias malignas do órgão no Brasil e é o tipo mais grave. Objetivo: Traçar o perfil epidemiológico, clínico, patológico e terapêutico dos pacientes a fim de identificar fatores de risco clínicos e patológicos. Metodologia: Estudo retrospectivo, observacional e transversal , que utilizou informações clínicas, epidemiológicas, histopatológicas e terapêuticas de prontuários eletrônicos de 46 pacientes acometidos por melanoma cutâneo , que receberam tratamento cirúrgico e foram atendidos pelos serviços de dermatologia e cirurgia oncológica do Hospital Universitário Evangélico Mackenzie. A busca pelos dados ocorreu no período de aplicação de termo de consentimento livre e esclarecido, de novembro de 2022 a fevereiro de 2023 Resultados: 76,1% da amostra realizou tratamento cirúrgico por exérese simples . Foi encontrada igual proporção dos sexos , cerca de 98% dos acometidos eram brancos e 89% afirmaram exposição solar intensa e queimaduras de repetição. A complicação mais encontrada do tratamento cirúrgico foi a amplicação de margens (34,8%), porém metade dos pacientes da amostra não apresentou nenhuma complicação. Os subtipos histológicos mais frequentes, ambos representando 43,2%, foram MM in situ e MM com disseminação superficial.Metástases não linfonodais acometeram 9 pacientes e linfonodais atingiram 11 pacientes. O tempo de seguimento médio foi de 22 meses e a maioria dos pacientes estava em seguimento clínico, portanto sem evidência de doença (56,5%), 37% tinham câncer em atividade e 3 foram a óbito devido a doença. Quanto a funcionalidade, medida pela escala de performance de Karnofsky , 30 pacientes mantiveram 100% de funcionalidade. Conclusão: O perfil epidemiológico do paciente acometido pelo melanoma cutâneo é predominantemente de indivíduos brancos, com histórico de exposição solar intensa e faixa etária mais avançada e houve igual proporção entre os sexos. O melanoma in situ e de disseminação superficial foram os subtipos mais prevalentes, os quais são tratados por excisão simples, sendo raras as complicações cirúrgicas. A atenção primária em saúde tem o importante papel de reconhecer e encaminhar pacientes com lesões suspeitas contribuindo para um diagnóstico mais precoce a fim de reduzir a morbidade dos pacientes.
Cutaneous melanoma is the malignant transformation of melanocytes which represents about 4% of the mallignancies of the skin in Brazil and turns out to be the worst of them.Objectives: Determine the epidemiological, clinical and pathological profile of the patients to identify clinical and pathological risks. Methods: Observational retrospective cross-sectional study that used clinical, epidemiological, histopathological and therapeutic data of 46 patients using their electronic medical records . These patients were all surgically treated and were followed up in dermatology and oncological surgery services of Hospital Universitários Evangélico Mackenzie. The data search took place during the application of an informed consent form , from November 2022 to Febuary 2023 .Results:: 76,1% of the patients were surgically treated by simple excision. Equal sex ratio was found, around 98% were white people and 89% had intense sun exposure and repeated sunburn. The most common surgical complication found was margin enlargement (34,8%) but half of the sample had none. The most frequent histological subtype found was melanoma in situ and superficial spreading melanoma , both representing 43,2%. Non-lymph node metastasis affected 9 patients and lymph node metastasis 11 patients.The average follow-up period was 22 months and most of them were on clinical follow up , which means no evidence of disease (56,5%), about 37% had active disease e 3 patients died from melanoma. The performance scale used was Karnofsky and about 30 patients remained 100% functional. Conclusion: The epidemiological profile of patients affected by cutaneous melanoma is mostly white individuals with a history of intense sun exposure, older age group and an equal sex ratio was found. Melanoma in situ and superficial spreading melanoma were the most prevalent subtype treated by simple excision and surgical complications were rare. To recognize and refer patients with suspected skin lesions is an important role of primary health care in order to have an early diagnosis and reduce patient morbidity.
Cutaneous melanoma is the malignant transformation of melanocytes which represents about 4% of the mallignancies of the skin in Brazil and turns out to be the worst of them.Objectives: Determine the epidemiological, clinical and pathological profile of the patients to identify clinical and pathological risks. Methods: Observational retrospective cross-sectional study that used clinical, epidemiological, histopathological and therapeutic data of 46 patients using their electronic medical records . These patients were all surgically treated and were followed up in dermatology and oncological surgery services of Hospital Universitários Evangélico Mackenzie. The data search took place during the application of an informed consent form , from November 2022 to Febuary 2023 .Results:: 76,1% of the patients were surgically treated by simple excision. Equal sex ratio was found, around 98% were white people and 89% had intense sun exposure and repeated sunburn. The most common surgical complication found was margin enlargement (34,8%) but half of the sample had none. The most frequent histological subtype found was melanoma in situ and superficial spreading melanoma , both representing 43,2%. Non-lymph node metastasis affected 9 patients and lymph node metastasis 11 patients.The average follow-up period was 22 months and most of them were on clinical follow up , which means no evidence of disease (56,5%), about 37% had active disease e 3 patients died from melanoma. The performance scale used was Karnofsky and about 30 patients remained 100% functional. Conclusion: The epidemiological profile of patients affected by cutaneous melanoma is mostly white individuals with a history of intense sun exposure, older age group and an equal sex ratio was found. Melanoma in situ and superficial spreading melanoma were the most prevalent subtype treated by simple excision and surgical complications were rare. To recognize and refer patients with suspected skin lesions is an important role of primary health care in order to have an early diagnosis and reduce patient morbidity.
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Palavras-chave
melanoma , melanoma maligno , epidemiologia , patologia , epidemiologia clínica , oncologia cirúrgica , neoplasias cutâneas , melanoma , malignant melanoma , epidemiology , pathology , clinical epidemiology , surgical oncology , skin neoplasm