Perfil epidemiológico do melanoma cutâneo de um hospital de referência em oncologia do Estado da Paraíba, entre os anos 2015 a 2019

Abstract

INTRODUCTION: Melanoma is an uncommon type of skin cancer that has its origin in the malignant transformation of melanocytes. It represents about 3 to 4% of all malignant skin tumors, but it is the one with the highest lethality. Its incidence has been progressively increasing around the world over the last decades. Therefore, becoming a relevant public health concern. There are few epidemiological studies on this tumor in the brazilian population and none has specifically been done in the state of Paraíba. OBJECTIVE: To evaluate the epidemiological profile of patients with histopathological diagnosis of melanoma, operated at the Napoleão Laureano Hospital in João Pessoa, Paraíba, between 2015 and 2019. METHODS: A cross-sectional study was carried out by collecting data from histopathological reports of patients diagnosed with melanoma who were operated at the Napoleão Laureano Hospital, analyzing the distribution of melanoma according to sex, age, color, education, tumor location, histological type, level of invasion (Clark), tumor thickness (Breslow), presence of angiolymphatic and perineural invasion, as well as the origin of the patients. Descriptive analysis was performed and chi-square tests were used, comparing two percentages. The significance level was 5%. RESULTS: There were 268 patients with histopathological diagnosis of melanoma, with a 1: 1 ratio between females and males. The ages of the patients ranged from 9 to 98 years, with a higher incidence in the group above 60 years. Most patients (48.9%) had only the fundamental level of education. 194 patients (72.4%) came from Mata Paraibana mesoregion, on the coast of the state. There has been a progressive increase in the number of new cases over the years, with 41 cases in 2015 and 69 cases in 2019. Among the identified tumors, 220 were primary cutaneous melanomas. Of these, 89 (40.5%) were in situ and 131 (59.5%) were invasive tumors. The most frequent subtype was superficial spreading melanoma with 100 cases (45.5%). Most patients (88 - 40%) were classified as Clark's level I and 133 patients (60.5%) had Breslow ¿1mm, no ulceration (174 - 74.5%), nor angiolymphatic (203 - 92,3%) or perineural invasion (194 - 88.2%). An association between being female and having a tumor ¿1.0 mm thick (p = 0.008) was found. There was an association between melanoma lesions in the trunk and male gender (p = 0.016). There was association (p <0.005) between having invasive melanoma and only primary level of education. An association was found between superficial spreading subtype and tumor thickness ¿1.0mm (p¿0.001). An association was found between thin melanomas (Breslow ¿1.0 mm) and the absence of ulceration, angiolymphatic invasion and perineural invasion (p¿0.001). CONCLUSION: In this population, melanoma occurred mostly on the trunk, with similar frequency between sexes, the superficial extensive subtype was the most common and invasive tumors were more frequent, although mostly with thickness of ¿1.0mm. Due to the increase in the number of new cases, knowledge of the behavior of melanoma in this region allows for better planning of public policies.