Baab G H, McBride C M
Arch Surg. 1975 Aug;110(8):896-900. doi: 10.1001/archsurg.1975.01360140040008.
Four percent of 2,446 patients with malignant melanoma did not have a known site of primary origin. More than half were admitted with nodal disease only, and were treated with regional node dissections. Thirty-three percent of this group lived five years, and 22 percent lived ten years following treatment. One third were admitted with visceral metastases, many of which were amenable to surgery, and this group experienced a 5 percent five-year survival rate. Cutaneous dissemination carried a lethal prognosis. Recurrences following treatment tended toward the same region of the body as the original metastasis, and 50 percent of these recurrences occurred within six months of therapy. The sex ratio, age incidence, family history, and survival rates in these patients with unknown primary tumors are consistent with an unnoticed cutaneous lesion as the site of origin for the metastatic disease. It must be supposed that this lesion had undergone spontaneous regression.
24466名恶性黑色素瘤患者中有4%的患者其原发灶不明。超过半数患者仅因淋巴结疾病入院，并接受了区域淋巴结清扫术。该组患者中有33%存活了五年，22%在接受治疗后存活了十年。三分之一的患者因内脏转移入院，其中许多患者适合手术治疗，该组患者的五年生存率为5%。皮肤播散预后不良。治疗后的复发倾向于发生在与原发转移相同的身体部位，其中50%的复发发生在治疗后的六个月内。这些原发肿瘤不明的患者的性别比例、年龄发病率、家族史和生存率与未被注意到的皮肤病变作为转移性疾病的起源部位是一致的。必须推测这种病变已经自发消退。
