Sutherland C M, Chmiel J S, Henson D E, Cunningham M P, Peace B B, Winchester D P
Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
Surg Gynecol Obstet. 1992 Aug;175(2):129-34.
The American College of Surgeons performed a patient care and evaluation study of melanoma for 1981 and 1987 to determine the presenting symptoms, methods of evaluation, clinical management and resulting outcome. Melanomas of the skin, eye, mucous membrane, metastases with unknown primary site and miscellaneous sites were included. Details concerning 5,004 patients from 681 hospitals in the study in 1981 and 6,900 patients from 844 hospitals in the study in 1987 were obtained--most melanomas were located in the skin; a decline in symptoms occurred at initial diagnosis; an increase in age at first diagnosis was reported; most melanomas were in Caucasian patients; slightly more melanomas occurred in men than women; more melanomas occurred in men on the head and neck and trunk, and more in the lower extremity in women; most tumors were not large in diameter; a significant shift was reported to lower levels of Clark's invasion, and a significant amount of unknowns existed in the Breslow's thickness of invasion. The large number of unknowns makes analysis difficult, but there seems to be some shift toward thinner levels of Breslow's in tumors in which it was known, from 1981 to 1987. Only a small proportion of patients in the current series was known to have node involvement or known distant metastases. An overall decline in diagnostic studies occurred between 1981 and 1987.
美国外科医师学会对1981年和1987年的黑色素瘤患者护理与评估进行了一项研究，以确定其呈现症状、评估方法、临床管理及最终结果。研究纳入了皮肤、眼部、黏膜、原发部位不明的转移瘤及其他部位的黑色素瘤。获取了1981年该研究中来自681家医院的5004例患者以及1987年该研究中来自844家医院的6900例患者的详细信息——大多数黑色素瘤位于皮肤；初诊时症状有所减少；报告称首次诊断时的年龄有所增加；大多数黑色素瘤患者为白种人；男性患黑色素瘤的人数略多于女性；男性的黑色素瘤更多发生在头颈部和躯干，而女性则更多发生在下肢；大多数肿瘤直径不大；据报告Clark侵袭水平有显著下降，且Breslow侵袭厚度存在大量未知情况。大量未知情况使得分析困难，但从1981年到1987年，在已知Breslow厚度的肿瘤中，似乎有向更薄水平转变的趋势。在当前系列中，只有一小部分患者已知有淋巴结受累或远处转移。1981年至1987年间，诊断性检查总体上有所减少。
