III期黑色素瘤患者淋巴结清扫范围的预后影响

The prognostic impact of the extent of lymph node dissection in patients with stage III melanoma.

作者信息

Galliot-Repkat C, Cailliod R, Trost O, Danino A, Collet E, Lambert D, Vabres P, Dalac S

机构信息

Department of Dermatology, University Hospital, 2 Boulevard Marechal de Lattre de Tassigny, F-21033 Dijon, France.

出版信息

Eur J Surg Oncol. 2006 Sep;32(7):790-4. doi: 10.1016/j.ejso.2006.04.004. Epub 2006 Jul 5.

DOI:10.1016/j.ejso.2006.04.004

PMID:16822643

Abstract

AIMS

To analyse disease-free and overall survival in 67 melanoma patients who underwent dissection for clinically apparent regional lymph node metastases, taking into account the total number of excised lymph nodes.

METHODS

After a median follow-up time of 16 months, 47 recurrences were observed and 43 patients died. The median disease-free and overall survival intervals were 14 and 24 months respectively.

RESULTS

Multivariate analyses revealed that the number of excised lymph nodes had a significant impact on overall survival (P=0.036) but not on disease-free survival (P=0.97). Extranodal growth was the only statistically significant prognostic factor both for disease-free (P=0.005) and overall (P=0.038) survival. Age, nodal basin, primary tumor ulceration, tumor thickness and number of positive lymph nodes were not significant prognostic factors.

CONCLUSIONS

Our results suggest that the total number of lymph nodes excised in the dissection has impact on overall survival of stage III melanoma patients and should be considered in clinical assays.

摘要

目的

分析67例因临床明显的区域淋巴结转移而接受清扫术的黑色素瘤患者的无病生存期和总生存期，并考虑切除淋巴结的总数。

方法

中位随访时间为16个月后，观察到47例复发，43例患者死亡。无病生存期和总生存期的中位间隔分别为14个月和24个月。

结果

多因素分析显示，切除淋巴结的数量对总生存期有显著影响（P = 0.036），但对无病生存期无显著影响（P = 0.97）。结外生长是无病生存期（P = 0.005）和总生存期（P = 0.038）唯一具有统计学意义的预后因素。年龄、淋巴结区域、原发肿瘤溃疡、肿瘤厚度和阳性淋巴结数量不是显著的预后因素。