Clinicopathological characteristics, diagnosis and treatment of melanoma in Serbia – the Melanoma Focus Study

Lidija Kandolf-Sekulović; Nada Babović; Neven Jokić; Mirjana Balić; Borislava Nikolin; Dejan Nikolić; Zlata Janjić; Željko Mijušković; Milica Rajović; Marijan Novaković; Svetislav Vrbić; Ivica Pejčić; Predrag Kovačević; Dragan Mihajlović; Tatjana Roganović; Vicko Ferenc; Jelena Nikolić; Marija Marinković; Zorana Bizetić

doi:10.2298/4657

Lidija Kandolf-Sekulović Clinic for Dermatovenerology, Military Medical Academy, Belgrade Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Nada Babović Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
Neven Jokić Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
Mirjana Balić Clinic for Oncology, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia
Borislava Nikolin Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia
Dejan Nikolić University Hospital Medical Center “Bežanijska Kosa”, Medical Faculty, University of Belgrade, Belgrade, Serbia
Zlata Janjić Clinic for Plastic and Reconstructive Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
Željko Mijušković Clinic for Dermatovenerology, Military Medical Academy, Belgrade Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Milica Rajović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic for Plastic and Reconstructive Surgery, Military Medical Academy, Belgrade Serbia
Marijan Novaković Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic for Plastic and Reconstructive Surgery, Military Medical Academy, Belgrade Serbia
Svetislav Vrbić Clinic for Oncology, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia
Ivica Pejčić Clinic for Oncology, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia
Predrag Kovačević Clinic for Plastic and Reconstructive Surgery, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia
Dragan Mihajlović Clinical Center Niš, Niš, Serbia
Tatjana Roganović Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia
Vicko Ferenc Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia
Jelena Nikolić Clinic for Plastic and Reconstructive Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
Marija Marinković Clinical Center of Vojvodina, Novi Sad, Serbia
Zorana Bizetić Institute of Oncology and Radiology of Serbia, Belgrade, Serbia

DOI: https://doi.org/10.2298/4657

Keywords: melanoma, diagnosis, neoplasm staging, neoplasm metastasis, therapeutics, clinical protocols,

Abstract

Background/Aim. Treatment options for metastatic melanoma in Serbia are limited due to the lack of newly approved biologic agents and the lack of clinical studies. Also, there is a paucity of data regarding the treatment approaches in different tertiary centers and efficacy of available chemotherapy protocols. The aim of this study was to obtain more detailed data about treatment protocols in Serbia based on structured survey in tertiary oncology centers. Methods. Data about the melanoma patients treated in 2011 were analyzed from hospital databases in 6 referent oncology centers in Serbia, based on the structured survey, with the focus on metastatic melanoma patients (unresectable stage IIIC and IV). Results. A total of 986 (79–315 in different centers) patients were treated, with 320 (32.45%) newly diagnosed patients. There were 317 patients in stage IIIC/IV, 77/317 aged < 50 years. At the time of diagnosis 47.3% of patients were < 60 years of age (24.2% < 40 years, 23% 50–59 years, 52.6% > 60 years). At initial diagnosis 12.5% of patients were in stage III and 4.5% in stage IV. The most common type was superficial spreading melanoma (50–66%), followed by nodular melanoma (23.5–50%). Apart from the regional and distant lymph node metastases, the most frequent organs involved in stage IV disease were distant skin and soft tissues (12–55%), lungs (19–55.5%), liver (10–60%), and bones (3–10%). The first line therapy in stage IV metastatic melanoma was dacarbazine (DTIC) dimethyl-triazeno-imidozole-carboxamide in 61–93% of the patients, while the second line varied between the centers. Disease control (complete response + partial response + stable disease) was achieved in 25.7% of the patients treated with the first line chemotherapy and 23.1% of the patients treated with the second line therapy, but the duration of response was short, in first-line therapy 6.66 ± 3.36 months (median 6.75 months). More than 90% of patients were treated outside the clinical trials. Conclusion. Based on this survey, there is a large unmet need for the new treatment options for metastatic melanoma in Serbia. The development of national guidelines, and greater involvement in international clinical studies could lead to widening of treatment options for this chemotherapy resistant disease.

Author Biographies

Lidija Kandolf-Sekulović, Clinic for Dermatovenerology, Military Medical Academy, Belgrade Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia

Prof. MD, PhD

Nada Babović, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia

MD, PhD

Neven Jokić, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia

MD

Mirjana Balić, Clinic for Oncology, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia

Prof., MD, PhD

Borislava Nikolin, Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia

Assistant Professor, MD, PhD

Dejan Nikolić, University Hospital Medical Center “Bežanijska Kosa”, Medical Faculty, University of Belgrade, Belgrade, Serbia

Associate professor, MD, PhD

Zlata Janjić, Clinic for Plastic and Reconstructive Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia

Prof. MD, PhD

Željko Mijušković, Clinic for Dermatovenerology, Military Medical Academy, Belgrade Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia

Associate professor, MD, PhD

Milica Rajović, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic for Plastic and Reconstructive Surgery, Military Medical Academy, Belgrade Serbia

MD

Marijan Novaković, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic for Plastic and Reconstructive Surgery, Military Medical Academy, Belgrade Serbia

Prof. MD, PhD

Ivica Pejčić, Clinic for Oncology, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia

MD PhD

Predrag Kovačević, Clinic for Plastic and Reconstructive Surgery, Clinical Center, Niš, Faculty of Medicine, Niš, Serbia

prof. MD, PhD

Dragan Mihajlović, Clinical Center Niš, Niš, Serbia

Prof. MD, PhD

Tatjana Roganović, Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia

MD, PhD

Vicko Ferenc, Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia

MD, PhD

Jelena Nikolić, Clinic for Plastic and Reconstructive Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia

MD

Marija Marinković, Clinical Center of Vojvodina, Novi Sad, Serbia

MD

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