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[I期恶性黑色素瘤的治疗]

[Treatment of stage I malignant melanoma].

作者信息

Fried G, Stein M, Borovik R, Ben Shachar M, Robinson E

机构信息

Northern Israel Oncology Center, Rambam Medical Center, Haifa.

出版信息

Harefuah. 1989 Sep;117(5-6):130-3.

PMID:2485754
Abstract

In 259 patients with malignant melanoma of the skin referred here during 1973-1984, the median follow-up was 46 months. Of 182 with stage I disease, 97 (53.2%) were women and 85 men. Of these, 90.1% were Jews of European extraction and 8.2% were Jews of Asian-African extraction, while only 1.8% were non-Jews. 171 (94%) of the patients were treated by wide excision, with or without skin graft, as primary treatment, while 11 had limited local excision. In 16.4% the primary tumor was located on the upper limbs, in 34.6% the lower limbs, in 27.5% the trunk and in 19.2% the head and neck. 5-year survival was 70%. The 5-year actuarial survival was significantly influenced by: age (those under 50 had better survival, 79.5% vs 58.4%, p less than 0.05); by site of the primary lesion (88.5% for those of the upper limbs vs 59.4% for those of the lower limbs), p less than 0.01]; by depth of invasion as seen microscopically (81.2% for Clark I-II vs 52.8% for Clark IV-V, p less than 0.02); and by site of recurrence (43.4% if local vs 0 for distant, p less than 0.02).

摘要

1973年至1984年间转诊至我院的259例皮肤恶性黑色素瘤患者,中位随访时间为46个月。182例I期患者中,97例(53.2%)为女性,85例为男性。其中,90.1%为欧洲裔犹太人,8.2%为亚非裔犹太人,而非犹太人仅占1.8%。171例(94%)患者接受了广泛切除治疗,无论是否进行皮肤移植,均作为初始治疗,11例接受了局部有限切除。16.4%的原发肿瘤位于上肢,34.6%位于下肢,27.5%位于躯干,19.2%位于头颈部。5年生存率为70%。5年精算生存率受以下因素显著影响:年龄(50岁以下患者生存率更高,79.5%对58.4%,p<0.05);原发灶部位(上肢患者为88.5%,下肢患者为59.4%),p<0.01];显微镜下观察到的浸润深度(Clark I-II级患者为81.2%,Clark IV-V级患者为52.8%,p<0.02);以及复发部位(局部复发为43.4%,远处复发为0),p<0.02)。

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