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对皮肤黑色素瘤患者进行2厘米半径内的再次切除——足以实现局部肿瘤根治。

Re-excision within a radius of 2 cm in patients with melanoma of the skin - sufficient for local oncological radicalness.

作者信息

Strashilov Strahil Asenov, Yordanov Angel Danchev, Vasileva-Slaveva Mariela Borisova, Konsoulova Assia Andrianova

机构信息

Department of Plastic Restorative, Reconstructive and Aesthetic Surgery, University Hospital "Dr. Georgi Stranski", Medical University Pleven, Pleven, Bulgaria.

Clinic of Gynecologic Oncology, University Hospital "Dr. Georgi Stranski", Medical University Pleven, Pleven, Bulgaria.

出版信息

Arch Med Sci. 2020 Jul 8;18(3):690-695. doi: 10.5114/aoms.2020.97056. eCollection 2022.

Abstract

INTRODUCTION

Malignant melanoma is one of the most malignant tumours in the human body. Radical re-excision of the tumour bed is a principal part of its surgical treatment. We aim to test the hypothesis that the re-excision with a 2 cm margin in all directions to the scar from the previous biopsy of the primary tumour provides sufficient local control in patients with this disease.

MATERIAL AND METHODS

This is a prospective descriptive study using STROBE methods, including all 151 patients with malignant melanoma of the skin, diagnosed and treated at the Department of Plastic, Reconstructive, and Aesthetic Surgery, Dr Georgi Stranski University Hospital, Medical University of Pleven, Bulgaria, in the period 2012-2016. Twenty-one cases were omitted from the study during the observation period due to lack of sufficient data. The re-excision was mainly within 2 cm margins in all directions to the scar from the previous biopsy of the primary tumour.

RESULTS

Data of all 130 patients with malignant skin melanoma, diagnosed and treated at our single large centre, were prospectively registered and analysed. These were 67 male and 63 female patients with a mean age at diagnosis of 61.6 years (range: 17-91 years). Using the re-excision within 2 cm margins, we identified only 1 (0.77%) patient with a histologically confirmed residual tumour in the re-excised flap. Local recurrence was observed in 13 (10%) patients.

CONCLUSIONS

Re-excision with a 2 cm margin is sufficient to achieve local surgical radicalness in the treatment of this disease without compromising oncological survival.

摘要

引言

恶性黑色素瘤是人体最恶性的肿瘤之一。肿瘤床的根治性再次切除是其外科治疗的主要部分。我们旨在验证这一假设,即对原发性肿瘤先前活检瘢痕周围各方向2厘米切缘的再次切除可为该疾病患者提供足够的局部控制。

材料与方法

这是一项采用STROBE方法的前瞻性描述性研究,纳入了2012年至2016年期间在保加利亚普列文医科大学乔治·斯特兰斯基大学医院整形、重建与美容外科诊断和治疗的所有151例皮肤恶性黑色素瘤患者。在观察期内,由于数据不足,21例病例被排除在研究之外。再次切除主要是在原发性肿瘤先前活检瘢痕周围各方向2厘米切缘范围内进行。

结果

对在我们单一大型中心诊断和治疗的所有130例皮肤恶性黑色素瘤患者的数据进行了前瞻性登记和分析。这些患者包括67名男性和63名女性,诊断时的平均年龄为61.6岁(范围:17 - 91岁)。采用2厘米切缘的再次切除,我们仅发现1例(0.77%)再次切除皮瓣中有组织学确诊的残留肿瘤患者。13例(10%)患者出现局部复发。

结论

2厘米切缘的再次切除足以在不影响肿瘤学生存率的情况下实现该疾病治疗的局部手术根治性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ab9/9103401/9d631496a298/AMS-18-3-123846-g001.jpg

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