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2022, vol. 61, br. 3, str. 49-53
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Dijagnoza i hirurško lečenje melanoma - kratki pregled
Diagnosis and surgical treatment of melanoma: A mini review
aUniverzitet u Nišu, Medicinski fakultet, Srbija + Klinički centar Niš, Klinika za plastičnu hirurgiju, Srbija bKlinički centar Niš, Klinika za plastičnu hirurgiju, Srbija
e-adresa: gste66@yahoo.com
Sažetak
Melanom je redak, ali najsmrtonosniji oblik karcinoma kože. U ranim fazama, melanom se može uspešno lečiti hirurški i stope preživljavanje su visoke. Međutim, kod bolesnika sa prisustvom metastaza, stopa preživljavanja značajno opada. Stoga su rana i ispravna dijagnoza, pravovremeno upućivanje i pravilno lečenje ključni za obezbeđivanje najbolje moguće prognoze bolesnika. Takođe, multidisciplanirni pristup veoma je važan. Dijagnoza melanoma uglavnom se postavlja dermoskopskim pregledom suspektnih, pigmentnih lezija. Pogrešna dijagnoza melanoma jedan je od najčešćih razloga pokretanja tužbi za pogresno lečenje, kada su patolozi i dermatolozi u pitanju, odmah posle raka dojke. Što se tiče lečenja metastatskog melanoma, u poslednjih 10 godina razvijeno je nekoliko novih lekova, koji su značajno poboljšali prognozu bolesnika koji boluju od ove bolesti. Međutim, većina bolesnika ne pokazuje trajni odgovor na ove tretmane. Stoga su potrebni novi biomarkeri i nova ciljna mesta za delovanje lekova, kako bi se poboljšali tačnost dijagnoze i lečenje melanoma. Ovaj članak govori o trenutnom stanju dijagnoze i lečenja melanoma kod nas i u svetu, na osnovu opšte prihvaćenog konsenzusa u ovoj oblasti i aktuelnih vodiča sa preporukama o lečenju. Takođe, pomenuti su i delovi koji su u algoritmu lečenja ostali otvoreni,tj. nedovoljno jasno definisani.
Abstract
Melanoma is a rare but the deadliest form of skin cancer. In the early stages, melanoma can be treated successfully by surgery and survival rates are high. However, in patients with metastases, survival rates drop significantly. Therefore, early and accurate diagnosis, prompt referral and proper management are crucial for ensuring the best prognosis. Also, multidisciplinary approach is necessary. The diagnosis of melanoma is usually made by dermoscopic examination of suspected pigmented lesions. Misdiagnosis of melanoma is one of the most common reasons for initiating lawsuits for wrong treatment, when it comes to pathologists and dermatologists, immediately after breast cancer. Regarding the treatment of metastatic melanoma, in the last 10 years several new drugs have been developed that have significantly improved the prognosis of patients suffering from this disease. However, a majority of patients do not show a lasting response to these treatments. Thus, new biomarkers and drug targets are needed to improve the accuracy of melanoma diagnosis and treatment. This article discusses the current state of melanoma diagnosis and treatment based on the generally accepted consensus in this area and current national guidelines for treatment recommendations. The parts that remained open in the treatment algorithm (i.e. insufficiently clearly defined) are also mentioned.
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