Hocevar M, Dragonja Z, Pilko G, Gazic B, Zgajnar J
Institute of Oncology, Dept. of Surgical Oncology, Zaloska 2, SI-1000 Ljubljana, Slovenia.
Institute of Oncology, Dept. of Surgical Oncology, Zaloska 2, SI-1000 Ljubljana, Slovenia.
Eur J Surg Oncol. 2014 Oct;40(10):1271-5. doi: 10.1016/j.ejso.2014.03.002. Epub 2014 Mar 12.
The aim of this study was to evaluate the effect of a residual melanoma after an excisional biopsy on prognosis of patients with cutaneous melanoma.
Between 2000 and 2007 sentinel lymph node biopsy with wide reexcision of a primary melanoma site was successfully performed in 692 patients (315 male and 377 female; mean age 55.7 years) at the Institute of Oncology Ljubljana, Slovenia. Clinicopathological data of all patients were extracted from a prospective institutional melanoma database and the frequency of local recurrences and survival were compared between patients with residual melanoma and those without it. For a statistical analysis univariate and multivariate analyses were used.
Only 25 (3.6%) patients had a residual melanoma. There was no difference in mean tumor thickness (3.9 and 2.8 mm) and ulceration (40% and 34%) of the primary melanoma between patients with and without residual melanoma. However, a number of local recurrences (16% versus 2.7%) and a number of metastases in sentinel lymph nodes (44% versus 22%) were significantly higher and a 5-year survival was significantly lower (64% versus 87.5%) in patients with residual melanoma. Breslow thickness, ulceration, positive SLNB and residual melanoma were independent prognostic factors for overall survival.
Residual melanoma is very rare after an excisional biopsy of the primary melanoma. However, when present it indicates a higher probability of local recurrence and a worse overall survival.
本研究的目的是评估切除活检后残留黑色素瘤对皮肤黑色素瘤患者预后的影响。
2000年至2007年间,斯洛文尼亚卢布尔雅那肿瘤研究所对692例患者(315例男性和377例女性;平均年龄55.7岁)成功进行了前哨淋巴结活检并对原发性黑色素瘤部位进行了广泛再次切除。从一个前瞻性机构黑色素瘤数据库中提取了所有患者的临床病理数据,并比较了有残留黑色素瘤患者和无残留黑色素瘤患者的局部复发频率和生存率。采用单因素和多因素分析进行统计学分析。
仅有25例(3.6%)患者有残留黑色素瘤。有残留黑色素瘤患者和无残留黑色素瘤患者的原发性黑色素瘤平均肿瘤厚度(分别为3.9和2.8mm)及溃疡情况(分别为40%和34%)无差异。然而,有残留黑色素瘤患者的局部复发数量(16%对2.7%)和前哨淋巴结转移数量(44%对22%)显著更高,5年生存率显著更低(64%对87.5%)。Breslow厚度、溃疡情况、前哨淋巴结活检阳性及残留黑色素瘤是总生存的独立预后因素。
原发性黑色素瘤切除活检后残留黑色素瘤非常罕见。然而,一旦存在则提示局部复发概率更高且总生存更差。