皮肤恶性黑色素瘤患者治疗性淋巴结清扫术后辅助化疗的长期结果

[Long-term results of adjuvant chemotherapy after therapeutic lymph node dissection in patients with cutaneous malignant melanoma].

作者信息

Kretschmer L, Helmbold P, Emmert S, Marsch W C

机构信息

Abteilung für Dermatologie und Venerologie, Georg-August-Universität Göttingen, Germany.

出版信息

Hautarzt. 2002 Aug;53(8):536-41. doi: 10.1007/s00105-002-0398-9.

DOI:10.1007/s00105-002-0398-9

PMID:12221468

Abstract

BACKGROUND AND OBJECTIVE

224 patients with malignant melanoma and palpable axillary or inguinal lymphadenopathy underwent therapeutic lymph node dissection at the Martin-Luther-University in Halle, Germany. between 1983 and 1994. 120 received adjuvant chemotherapy; we evaluated the effects of various regimens in this group.

PATIENTS/METHODS: Surgical treatment alone was performed in 104 patients. This group's results were compared to those of 94 patients who additionally received an adjuvant polychemotherapy [dacarbazine (DTIC), vincristine, 5-fluorouracil and hydroxyurea] and 26 patients who received either DTIC monotherapy or DTIC plus interferon-alfa.

RESULTS

The median follow-up was 88 months. The 5-year survival rates were 31.0+/-5% after surgery alone, 26.4+/-4% after adjuvant polychemotherapy and 27.0+/-9% after DTIC based chemotherapy. The three survival curves did not differ significantly. In a multifactorial analysis, the number of metastatic lymph nodes was the single significant predictor of survival after therapeutic lymph node dissection, whereas Breslow thickness, ulceration, site of the primary melanoma, age, sex and adjuvant therapy were not significant.

CONCLUSION

No beneficial effect of adjuvant chemotherapies could be demonstrated.

摘要

背景与目的

1983年至1994年间，德国哈雷市马丁 - 路德大学对224例患有恶性黑色素瘤且可触及腋窝或腹股沟淋巴结病的患者进行了治疗性淋巴结清扫术。其中120例接受了辅助化疗；我们评估了该组中各种化疗方案的效果。

患者/方法：104例患者仅接受了手术治疗。将该组患者的结果与另外94例接受辅助多药化疗（达卡巴嗪、长春新碱、5 - 氟尿嘧啶和羟基脲）的患者以及26例接受达卡巴嗪单药治疗或达卡巴嗪加干扰素 - α治疗的患者的结果进行了比较。

结果

中位随访时间为88个月。单纯手术后的5年生存率为31.0±5%，辅助多药化疗后的5年生存率为26.4±4%，基于达卡巴嗪的化疗后的5年生存率为27.0±9%。三条生存曲线无显著差异。在多因素分析中，转移性淋巴结的数量是治疗性淋巴结清扫术后生存的唯一显著预测因素，而Breslow厚度、溃疡、原发性黑色素瘤的部位、年龄、性别和辅助治疗均无显著意义。