Jonk A, Kroon B B, Rümke P, Mooi W J, Hart A A, van Dongen J A
Division of Clinical Oncology, The Netherlands Cancer Institute, (Antoni van Leeuwenhoek Huis), Amsterdam.
Br J Surg. 1990 Jun;77(6):665-8. doi: 10.1002/bjs.1800770625.
Twenty-six patients, treated surgically between 1961 and 1986 because of lymph node metastasis from melanoma with an unknown primary, were analysed. Six patients had a history of spontaneous regression of a skin lesion. Following node dissection, the overall actuarial disease-free survival rate was 49 per cent, after both 5 and 10 years. When considered as single factors, female (versus male), one lymph node involved (versus more than one node involved) and site of metastasis in the groin or axilla (versus the neck) were found to have significantly favourable effects on prognosis with 5-year survival rates of 82 per cent (25 per cent), 82 per cent (27 per cent) and 80 per cent (11 per cent) respectively. However, at multifactorial analysis only the site of cervical metastases maintained a significant influence on survival (P = 0.005). As survival in this series is comparable with, or even better than, that of adequately treated patients with lymph node metastasis from a known primary melanoma, a radical node dissection is essential also in these patients.
对1961年至1986年间因原发性不明的黑色素瘤淋巴结转移而接受手术治疗的26例患者进行了分析。6例患者有皮肤病变自发消退史。淋巴结清扫术后，5年和10年后的总体精算无病生存率均为49%。当作为单一因素考虑时，女性（与男性相比）、累及一个淋巴结（与累及多个淋巴结相比）以及腹股沟或腋窝转移部位（与颈部相比）对预后有显著的有利影响，5年生存率分别为82%（25%）、82%（27%）和80%（11%）。然而，在多因素分析中，只有颈部转移部位对生存仍有显著影响（P = 0.005）。由于该系列患者的生存率与已知原发性黑色素瘤淋巴结转移且得到充分治疗的患者相当，甚至更好，因此对这些患者进行根治性淋巴结清扫也是必不可少的。
