Grünhagen Dirk J, Eggermont Alexander M M, van Geel Albertus N, Graveland Wilfried J, deWilt Johannes H W
Department of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands.
Melanoma Res. 2005 Jun;15(3):179-84. doi: 10.1097/00008390-200506000-00006.
Cervical lymph node dissection (CLND) is the surgical therapy used for the local control of regionally metastasized cutaneous head and neck melanoma. This study evaluated the outcome of patients undergoing CLND at our institution in order to determine the prognostic factors for recurrence-free survival and overall survival after this procedure. The hospital records of 66 patients with histologically proven lymph node metastases who underwent curative or palliative CLND between 1982 and 2004 were analysed. The characteristics of the patients, the primary tumour and the surgical procedure were recorded. During follow-up, the incidence of local or distant recurrences was recorded and the survival was determined. Of the 66 patients, a (modified) radical neck dissection was performed in 20 and a selective procedure in 46. The 5-year actuarial overall survival was 26% and the recurrence-free survival was 22%. Neither the primary tumour characteristics nor the extent of surgery was of prognostic value; the number of positive nodes affected both the overall survival (P=0.046) and overall recurrence-free survival (P<0.001). Selective CLND is the recommended procedure for patients with cervical metastases of cutaneous melanoma. The number of positive lymph nodes significantly affects the outcome of the patients.
颈部淋巴结清扫术（CLND）是用于局部控制区域转移的皮肤头颈黑色素瘤的外科治疗方法。本研究评估了在我们机构接受CLND的患者的预后，以确定该手术后无复发生存和总生存的预后因素。分析了1982年至2004年间66例经组织学证实有淋巴结转移且接受了根治性或姑息性CLND的患者的医院记录。记录了患者、原发肿瘤和手术操作的特征。随访期间，记录局部或远处复发的发生率并确定生存率。66例患者中，20例行（改良）根治性颈清扫术，46例行选择性手术。5年精算总生存率为26%，无复发生存率为22%。原发肿瘤特征和手术范围均无预后价值；阳性淋巴结数量对总生存（P=0.046）和无复发生存（P<0.001）均有影响。对于皮肤黑色素瘤颈部转移患者，推荐行选择性CLND。阳性淋巴结数量显著影响患者预后。
