McBride C M, Sugarbaker E V, Hickey R C
Ann Surg. 1975 Sep;182(3):316-24. doi: 10.1097/00000658-197509000-00014.
The most common causes of treatment failure in patients with malignant melanoma treated by surgical therapy alone are local or regional recurrences. These are presumed to be due to occult metastasis present at the time of the initial treatment. In an effort to control this occult regional disease, 202 patients with Stage I malignant melanoma underwent isolation-perfusion with 1-phenylalanine mustard between the years 1960 and 1970. The 2-5 and 10-year determinate survival rates were 98%, 86% and 83%, respectively. In these patients, 2% developed local recurrences, 3% developed intransit metastasis, 18% developed positive regional lymph nodes and 6% developed disseminated disease, as their first evidence of recurrence. Over 40% of these patients were benefitted by further therapy. When regional perfusion is used, the question of prophylactic lymph node dissection need not arise. There was one surgical death in this series and only a few patients had symptomatology referable to their limbs beyond 3 months.
仅接受手术治疗的恶性黑色素瘤患者治疗失败的最常见原因是局部或区域复发。这些复发被认为是由于初始治疗时存在隐匿性转移。为了控制这种隐匿性区域疾病，1960年至1970年间，202例I期恶性黑色素瘤患者接受了苯丙氨酸氮芥隔离灌注治疗。2年、5年和10年的确定生存率分别为98%、86%和83%。在这些患者中，2%出现局部复发，3%出现途中转移，18%出现区域淋巴结阳性，6%出现播散性疾病，作为复发的首个证据。超过40%的这些患者从进一步治疗中受益。当采用区域灌注时，不必考虑预防性淋巴结清扫问题。该系列中有1例手术死亡，只有少数患者在3个月后出现与肢体相关的症状。
