Innovative One Step Melanoma Surgical Approach (OSMS): Not a Myth-It’s a Reality! Case Related Analysis of a Patient with a Perfect Clinical Outcome Reported from the Bulgarian Society for Dermatologic Surgery (BULSDS)!

Authors

  • Georgi Tchernev Medical Institute of Ministry of Interior (MVR-Sofia), Department of Dermatology, Venereology and Dermatologic Surgery, General Skobelev Nr 79, Sofia 1606 Bulgaria; Onkoderma - Policlinic for Dermatology and Dermatologic Surgery, General Skobelev 26, Sofia 1407
  • Svetoslav Chernin Medical Institute of Ministry of Interior, Department of Common, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia
  • Ilia Lozev Medical Institute of Ministry of Interior, Department of Common, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia
  • Torello Lotti University of Rome G. Marconi, Institute of Dermatology, Rome 00186
  • Konstantin Stavrov Medical Institute of Ministry of Interior, Department of Common, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia
  • Ivanka Temelkova Medical Institute of Ministry of Interior, Department of Common, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia
  • Ivan Pidakev Medical Institute of Ministry of Interior, Department of Common, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia

DOI:

https://doi.org/10.3889/oamjms.2018.194

Keywords:

melanoma surgery, innovations, treatment options, survival, surgical approach

Abstract

BACKGROUND: With the newly described one step melanoma surgical approach, some patient groups could be successfully treated within one surgical session. Depending on the tumour thickness (measured preoperatively) at a later stage (also depending on the ultrasound findings of the locoregional lymph nodes) the respective surgical intervention is planned with the respective field of surgical safety (one-stage melanoma surgery with or without removal of lymph nodes). The innovations could make to some extent some of the already existing algorithms more difficult (due to the introduction of a high-frequency ultrasound to determine the tumor thickness preoperatively as an absolute prerequisite for dermosurgical centres), but it would also lead with absolute certainty to better or least optimal results regarding the prognosis, the side effects and the financial factor also.

CASE REPORT: We present a patient from the Department of Dermatology, Venereology and Dermatologic Surgery at the Medical Institute-Ministry of Interior (MVR-Sofia), treated with the one-step melanoma surgery method with perfect final results. The preoperative tumour thickness determined via ultrasound and the postoperatively measured histological tumour thickness was identical: between 0.98 and 1 mm, which allowed removal of the melanoma lesion with a field of surgical security of 1 cm in all directions and did not require additional removal of a draining lymph node or excisions.

CONCLUSION: Thanks to this new approach, some patients could avoid one surgical intervention, which could be interpreted as a significant advantage or probably also survival benefit. This methodology and its successful application were first officialised by the representatives of the Bulgarian Society for Dermatologic Surgery- (BULSDS), and the purpose of this action, in general, is to fully improve clinical management of patients suffering from cutaneous melanoma in terms of compactness by 1) reducing the number of unnecessary surgeries or the number of surgical interventions in general; 2) reducing side effects occurring in surgeries and 3) introducing a serious optimization in terms of financial resources needed or used in the second hospitalization of patients. The question remains open whether the accepted or the current recommendations for surgical treatment of melanoma will be transformed or adapted for the matching patient groups.

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References

Tchernev G, Chokoeva AA. New Safety Margins for Melanoma Surgery: Nice Possibility for Drinking of "Just That Cup of Coffee"? Open Access Maced J Med Sci. 2017; 5(3):352-358. https://doi.org/10.3889/oamjms.2017.068 PMid:28698757 PMCid: PMC5503737

Tchernev G. One Step Surgery for Cutaneous Melanoma: "We Cannot Solve Our Problems with the Same Thinking We Used When We Created Them?" Open Access Maced J Med Sci. 2017; 5(6):774-776. https://doi.org/10.3889/oamjms.2017.168 PMid:29531606 PMCid:PMC5839450

Tchernev G. Novel Surgical Approach in Cutaneous Melanoma Patients: "Daring Ideas Are Like Chessmen Moved Forward. They May Be Beaten, But they May Start a Winning Game!?"Open Access Maced J Med Sci. 2017; 5(6):810-812. https://doi.org/10.3889/oamjms.2017.199 PMid:29104697 PMCid:PMC5661726

Published

2018-04-14

How to Cite

1.
Tchernev G, Chernin S, Lozev I, Lotti T, Stavrov K, Temelkova I, Pidakev I. Innovative One Step Melanoma Surgical Approach (OSMS): Not a Myth-It’s a Reality! Case Related Analysis of a Patient with a Perfect Clinical Outcome Reported from the Bulgarian Society for Dermatologic Surgery (BULSDS)!. Open Access Maced J Med Sci [Internet]. 2018 Apr. 14 [cited 2022 Oct. 1];6(4):673-4. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.194

Issue

Section

C- Case Reports

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