University Hospital Waterford: 5-year experience of cutaneous melanoma

• Published in: Irish journal of medical science Vol. 186; no. 2; pp. 309 - 314
• Main Authors: Sehgal, R., Cheung, C. X., Alradadi, R., Healy, D. A., Landers, R., O’Donoghue, G. T.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.05.2017
• Subjects: Adult; Aged; Aged, 80 and over; Axilla; Family Medicine; Female; General Practice; Hospitals, University; Humans; Hutchinson's Melanotic Freckle - epidemiology; Incidence; Internal Medicine; Ireland - epidemiology; Male; Medicine; Medicine & Public Health; Melanoma - epidemiology; Melanoma - pathology; Middle Aged; Neoplasm Recurrence, Local - surgery; Original Article; Prognosis; Retrospective Studies; Sentinel Lymph Node Biopsy - methods; Skin Neoplasms - epidemiology; Diagnosis; Excision; Biopsy; Surgery; Melanoma; Interval
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-016-1531-6

Introduction The incidence of cutaneous melanoma (CM) continues to rise in Ireland. Despite significant advances in melanoma molecular therapy, surgery remains the mainstay of treatment for CM. The University Hospital Waterford (UHW) prospectively maintained CM registry was established in 2010. Aim To summarize 5-year experience (2010–2015) of primary CM presenting to UHW. Methods Data were retrospectively obtained from a central electronic pathology and radiology repository augmented by HIPE data and theatre logs. Data collected included patient demographics and clinico-pathological characteristics, specimen number, size, anatomical location, melanoma subtype, Breslow thickness, Clark’s level, ulceration, and mitosis. Results 592 CMs were managed in UHW during the study period. Overall, females comprised the majority of cases with mean age at presentation 60.78 ± 18.29 years. The most commonly affected anatomical location was the lower limb (26.7%) followed by the back (15.1%), upper limb (15.07%), and face (14.40%). Superficial spreading and lentigo maligna were the most common histological subtype accounting for 19.8 and 20%, respectively. Overall, the mean Breslow depth was 2.4 ± 3.7 mm with corresponding Clark’s Level III. Sentinel lymph node positivity was 39/103 (37.89%) most commonly located in the axilla (53.8%) and groin (30.7%). Conclusion There has been a steady increase in the number of cutaneous melanoma presentations over the past 5-years to the South East Cancer Centre. Patients are managed best by prompt surgical excision and multidisciplinary management. Our results are in keeping with international standards and work continues in determining overall 5-year survival and recurrence rates.