Vreeburg G C, Schouwenburg P F, Hilgers F J, de Kraker N W, Hart A A
Department of ENT-Head and Neck Surgery, The Netherlands Cancer Institute (Antoni van Leeuwenhoek Huis), Amsterdam.
Eur J Surg Oncol. 1988 Apr;14(2):165-70.
Seventy patients surgically treated in The Netherlands Cancer Institute between 1969 and 1984 for cutaneous melanoma of the head and neck were reviewed with regard to patient data, tumor site, stage, histological criteria, treatment, disease-control and survival. The objectives of the study were to analyse the results of curative treatment of cutaneous melanoma of the head and neck, the value of prognostic factors and the treatment policy for the N0 and N+ neck. Tumor thickness (Breslow Index) was by far the most important prognostic factor in cutaneous melanoma of the head and neck. Other known important factors like level of invasion, tumor subsite, stage, tumor type and ulceration provided additional information. Elective node dissection is advised in lesions thicker than 1.5 mm since N0-N+ transformation is seen in 37% of these patients. Partial neck dissection which includes removal of the nodes adjacent to the primary provides proper regional control except for primary lesions in the neck that require at least a modified neck dissection.
对1969年至1984年间在荷兰癌症研究所接受手术治疗的70例头颈部皮肤黑色素瘤患者的患者资料、肿瘤部位、分期、组织学标准、治疗、疾病控制和生存情况进行了回顾。本研究的目的是分析头颈部皮肤黑色素瘤的根治性治疗结果、预后因素的价值以及N0和N+颈部的治疗策略。肿瘤厚度（Breslow指数）是头颈部皮肤黑色素瘤迄今为止最重要的预后因素。其他已知的重要因素，如浸润深度、肿瘤亚部位、分期、肿瘤类型和溃疡情况，可提供额外信息。对于厚度超过1.5 mm的病变，建议进行选择性淋巴结清扫，因为这些患者中有37%会出现N0-N+转变。除颈部原发性病变至少需要改良颈清扫外，包括切除原发灶附近淋巴结的部分颈清扫可提供适当的区域控制。
