Loree T R, Spiro R H
Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
Am J Surg. 1989 Oct;158(4):388-91. doi: 10.1016/0002-9610(89)90141-4.
We have reviewed a 21-year experience with 289 patients who received definitive surgical treatment for cutaneous melanomas arising in the skin of the head and neck. Elective lymphadenectomy was performed in 39 percent of those who presented with no clinical evidence of nodal metastasis. The cumulative 5- and 10-year survival was 56 percent and 45 percent, respectively. Increased tumor thickness, age greater than 55 years, male sex, ulceration, nodular morphology, and scalp site were significant adverse factors. Patients with ear or neck lesions had the best survival. The risk of distant metastasis was almost equivalent to that of nodal metastasis, regardless of thickness. Elective lymphadenectomy appeared to have minimal impact on survival.
我们回顾了289例接受头颈部皮肤原发性黑色素瘤确定性手术治疗患者的21年经验。39%无临床淋巴结转移证据的患者接受了选择性淋巴结清扫术。5年和10年累积生存率分别为56%和45%。肿瘤厚度增加、年龄大于55岁、男性、溃疡、结节形态和头皮部位是显著的不良因素。耳部或颈部病变患者的生存率最佳。无论肿瘤厚度如何，远处转移风险几乎与淋巴结转移风险相当。选择性淋巴结清扫术对生存率的影响似乎微乎其微。
