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胃肠道恶性黑色素瘤的外科治疗:外科培训中心的经验。

Surgery for gastrointestinal malignant melanoma: experience from surgical training center.

机构信息

Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

出版信息

World J Gastroenterol. 2010 Feb 14;16(6):745-8. doi: 10.3748/wjg.v16.i6.745.

Abstract

AIM

To characterize clinical features, surgery, outcome, and survival of malignant melanoma (MM) of the gastrointestinal (GI) tract in a surgical training center in Bangkok, Thailand.

METHODS

A retrospective review was performed for all patients with MM of the GI tract treated at our institution between 1997 and 2007.

RESULTS

Fourteen patients had GI involvement either in a metastatic form or as a primary melanoma. Thirteen patients with sufficient data were reviewed. The median age of the patients was 66 years (range: 32-87 years). Ten patients were female and three were male. Seven patients had primary melanomas of the anal canal, stomach and the sigmoid colon (5, 1 and 1 cases, respectively). Seven patients underwent curative resections: three abdominoperineal resections, two wide local excisions, one total gastrectomy and one sigmoidectomy. Six patients had distant metastatic lesions at the time of diagnosis, which made curative resection an inappropriate choice. Patients who underwent curative resection exhibited a longer mean survival time (29.7 mo, range: 10-96 mo) than did patients in the palliative group (4.8 mo, P = 0.0006).

CONCLUSION

GI MM had an unfavorable prognosis, except in patients who underwent curative resection (53.8% of cases), who had a mean survival of 29.7 mo.

摘要

目的

在泰国曼谷的一个外科培训中心,对胃肠道(GI)恶性黑色素瘤(MM)的临床特征、手术、结果和生存情况进行描述。

方法

对 1997 年至 2007 年期间在我院接受治疗的胃肠道 MM 患者进行回顾性分析。

结果

14 例患者存在胃肠道受累,或是转移形式,或是原发性黑色素瘤。对 13 例具有足够数据的患者进行了审查。患者的中位年龄为 66 岁(范围:32-87 岁)。10 例为女性,3 例为男性。7 例患者的原发性黑色素瘤位于肛门、胃和乙状结肠(分别为 5、1 和 1 例)。7 例患者接受了根治性切除术:3 例经腹会阴切除术,2 例广泛局部切除术,1 例全胃切除术和 1 例乙状结肠切除术。6 例患者在诊断时即存在远处转移病灶,因此根治性切除术并非合适的选择。接受根治性切除术的患者的平均生存时间(29.7 个月,范围:10-96 个月)长于姑息治疗组(4.8 个月,P=0.0006)。

结论

除接受根治性切除术(占 53.8%)的患者外,胃肠道 MM 的预后不佳,其平均生存时间为 29.7 个月。

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