Plastic surgery of skin melanoma as a factor of better survival of patients
Introduction. Melanoma is one of the most deadly human skin tumors, and surgery remains the first and main method in its combined treatment. Despite the seemingly radical nature of surgical interventions in patients with primary skin melanoma, the frequency of locoregional recurrence and metastasis remains high.Objective. To analyze the effect on the survival rate of the use of plastic methods to close the surgical tissue defect in patients with primary melanoma of the skin after tumor removal in comparison with patients in whom plastic surgery was not used.Materials and methods. The study used data from 337 patients with stage 0-IIIc primary skin melanoma, randomized into 2 groups: the main group (with the use of plastic closure of a postoperative tissue defect) and the comparison group (with linear suturing of a tissue defect).Results. It was found that the use of plastic replacement of tissue defect in patients with localized forms of skin melanoma shows the best results of 5-year progression-free survival from 22 to 22.6% (p < 0.050), and at stage 0-IIa and in 5-year corrected overall survival rate up to 13.1% (p < 0.050).Conclusions. Performing plastic replacement of a tissue defect reduces wound edge tension and rough scarring, accelerates postoperative healing, may be an independent prognostic factor that improves progression-free survival and adjusted overall survival of patients with primary localized skin melanoma, and also be the method of choice among other methods.