Management of Skin Malignancies: Lessons Learnt at a Tertiary Care Center in Northern India

JOURNAL TITLE: Journal of Postgraduate Medicine, Education and Research

Author
1. Abhinav Singh
2. Siddhant Khare
3. Rajender Kumar
4. Palak Singhai
5. Santosh Irrinki
6. Debajyoti Chatterjee
ISSN
2277-8969
DOI
10.5005/jp-journals-10028-1567
Volume
56
Issue
2
Publishing Year
2022
Pages
7
Author Affiliations
    1. Department of General Surgery, PGIMER, Chandigarh, India
    1. People’s College of Dental Sciences and Research Center, Bhopal, Madhya Pradesh, India
    1. Department of General Surgery, PGIMER, Chandigarh, India
    1. Department of General Surgery, PGIMER, Chandigarh, India
    1. Department of General Surgery, PGIMER, Chandigarh, India
    1. Department of General Surgery, PGIMER, Chandigarh, India
  • Article keywords
    BCC, DMFSP, Melanoma, Merkel cell carcinoma, SCC, Skin cancer

    Abstract

    Introduction: The prognosis of skin cancers in India is worse when compared to the Western countries. It may be because of overall rarity and low experience at individual centers, presentation with advanced disease, inadequate first treatment and a higher incidence of poor prognostic disease subtypes. Aims and objectives: To analyze the clinicopathological characteristics, recurrence patterns and the completeness of first treatment in the patients with skin cancers. Materials and methods: It was a retrospective analysis of all patients operated for skin cancers. Mean and SD was computed for normal data; for skewed data, median and IQR were used. Kaplan-Meier analysis was used to assess the survival. Results: There were 18 cases of skin malignancies of which 8 (44.4%) patients had MM 5 (27.8%) had SCC 2 (11.1%) each had BCC and DMFSP and 1 (5.6%) had MCC. Pain was the most common presenting symptom (55.6%). The median follow-up was 12.25 months (Range 2–21.5 months). Ten (55.6%) patients had received a primary treatment elsewhere, not in accordance with the standard treatment guidelines. The median delay between the primary treatment and definitive surgery was 8 months (Range 2.5–48 months) which led to an increase in surgical morbidity in at least 4 (40%) of these patients. Median disease-free survival in the study was 12 months. Conclusion: Skin cancers have poor outcomes in Indian patients when compared to the Western countries. Awareness programs for early diagnosis, a high index of suspicion and early referral to a center experienced in handling these malignancies may help in improving outcomes.

    © 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved