Brega K, Robinson W A, Winston K, Wittenberg W
Department of Neurosurgery, University of Colorado, Denver.
Cancer. 1990 Nov 15;66(10):2105-10. doi: 10.1002/1097-0142(19901115)66:10<2105::aid-cncr2820661011>3.0.co;2-i.
The authors report the results of a retrospective review of 13 patients who underwent 19 craniotomies for resection of metastatic malignant melanoma at the University of Colorado (Denver, CO) between 1983 and 1989. There was preoperative evidence of extracranial disease in 11 patients. Eight patients had more than one intracranial metastasis at operation. Intraoperative ultrasound was used in 18 of the 19 craniotomies to minimize surgical trauma to the brain. The 30-day mortality was zero. The 30-day morbidity was minimal. No patient acquired a new neurologic deficit as a result of surgery. All patients regained at least their preoperative level of functioning. Six of the patients who were living at the time of review have been followed for 4 to 25 months (median, 7.5 months). The seven patients who were dead at the time of review survived 4 to 18 months (median, 10 months). These results compare favorably with the survival of untreated patients with metastatic melanoma to the brain (median, 1 month), patients treated with radiation therapy alone (median, 2-4 months), and those treated with chemotherapy alone (median, 2-4 months). The excision of metastatic melanoma from the brain, although not curative, may increase survival in patients with this problem with little morbidity and mortality even in the presence of other metastases.
作者报告了对13例患者进行回顾性研究的结果，这些患者于1983年至1989年期间在科罗拉多大学（丹佛，科罗拉多州）接受了19次开颅手术以切除转移性恶性黑色素瘤。11例患者术前有颅外疾病的证据。8例患者在手术时有不止一处颅内转移。19次开颅手术中有18次使用了术中超声，以尽量减少对脑的手术创伤。30天死亡率为零。30天发病率极低。没有患者因手术出现新的神经功能缺损。所有患者至少恢复到术前的功能水平。在复查时仍存活的6例患者已随访4至25个月（中位数为7.5个月）。在复查时已死亡的7例患者存活了4至18个月（中位数为10个月）。这些结果与未治疗的脑转移性黑色素瘤患者（中位数为1个月）、仅接受放射治疗的患者（中位数为2 - 4个月）以及仅接受化疗的患者（中位数为2 - 4个月）的生存率相比更有利。从脑中切除转移性黑色素瘤，虽然不能治愈，但即使存在其他转移，也可能提高此类患者的生存率，且发病率和死亡率很低。
