Department of Surgery, Division of Surgical Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
J Surg Oncol. 2011 Apr;103(5):426-30. doi: 10.1002/jso.21846. Epub 2010 Dec 28.
The face is a common site of melanoma occurrence. The purpose of this study was to examine the management and outcomes of patients with invasive melanoma of the face.
Patients with invasive melanoma of the face managed at our institution from 1997 to 2008 were retrospectively reviewed. Details of sentinel lymph node biopsy (SNB), disease recurrence, and deaths were recorded.
Two hundred sixty patients were reviewed (mean age 68, mean tumor thickness 0.87 mm). Of 100 patients eligible for SNB (tumor thickness ≥ 1 mm, Clark level ≥ IV, or ulceration) this was performed in only 29 (29%), and those who underwent SNB were younger than those who did not (mean age 59 vs. 79 years, P < 0.0001). SNB was successful in 28 (97%), and no complications occurred. SNB was positive in 3 (11%). After mean follow-up of 30 months, nodal recurrence occurred in 9 (3.5%) and distant recurrence in 20 (7.7%). There were 60 deaths (overall mortality 23%); attributed to melanoma in only 16 cases (disease specific mortality 6.2%).
Facial melanoma is associated with low rates of regional recurrence despite underutilization of SNB. Older patients are less likely to undergo SNB. Due to the advanced age of patients with facial melanoma, most deaths occurring are from unrelated causes.
面部是黑素瘤发生的常见部位。本研究旨在探讨面部侵袭性黑素瘤患者的治疗方法和结局。
回顾性分析 1997 年至 2008 年在我院接受治疗的面部侵袭性黑素瘤患者。记录患者的前哨淋巴结活检（SNB）、疾病复发和死亡情况。
共纳入 260 例患者（平均年龄 68 岁，平均肿瘤厚度 0.87mm）。100 例符合 SNB 条件（肿瘤厚度≥1mm、Clark 分级≥IV 级或溃疡）的患者中，仅 29 例（29%）接受了 SNB，接受 SNB 的患者比未接受 SNB 的患者更年轻（平均年龄 59 岁比 79 岁，P<0.0001）。28 例（97%）SNB 成功，无并发症发生。3 例（11%）SNB 阳性。平均随访 30 个月后，9 例（3.5%）出现淋巴结复发，20 例（7.7%）出现远处复发。共有 60 例患者死亡（总死亡率 23%），仅 16 例（疾病特异性死亡率 6.2%）归因于黑素瘤。
尽管 SNB 应用不足，但面部黑素瘤的区域复发率仍较低。老年患者更不可能接受 SNB。由于面部黑素瘤患者年龄较大，大多数死亡是由非黑素瘤相关原因导致的。
