Breslow A
Ann Surg. 1975 Nov;182(5):572-5. doi: 10.1097/00000658-197511000-00007.
From a retrospective study of 97 and a prospective study of 41 Stage I cutaneous melanomas, it was found that tumor thickness is a better measure of prognosis than is the level of invasion of the tumor. The chance of developing recurrent disease appears to be directly proportional to tumor thickness. Prophylactic lymph node dissection doubled the rate of survival for patients with lesions greater than 1.50 mm thick but had no effect on those with thinner lesions. Thirty-nine per cent of the patients had lesions less than 0.76 mm thick and all survived free of disease for 5 or more years. Six per cent of the tumors that recurred or metastasized were in an intermediate range of 0.76-1.50 mm thick, and no discriminant could be found to separate these 9 lesions with a bad prognosis from the remaining 18 in this group.
通过对97例一期皮肤黑色素瘤的回顾性研究和41例的前瞻性研究发现，肿瘤厚度比肿瘤浸润水平更能准确衡量预后。发生复发性疾病的几率似乎与肿瘤厚度成正比。预防性淋巴结清扫术使肿瘤厚度大于1.50毫米的患者生存率提高了一倍，但对较薄病变的患者没有效果。39%的患者病变厚度小于0.76毫米，所有患者均存活且5年或更长时间无疾病。复发或转移的肿瘤中有6%厚度处于0.76 - 1.50毫米的中间范围，无法找到鉴别方法将这9例预后不良的病变与该组中其余18例区分开来。
