Schneebaum S, Briele H A, Walker M J, Greager J, Wood D K, Ronan S G, Patel M K, Das Gupta T K
Arch Surg. 1987 Jun;122(6):707-11. doi: 10.1001/archsurg.1987.01400180089017.
Among proponents of elective lymph node dissection (ELND) for clinical stage I melanoma, controversy exists as to whether there is an upper limit of tumor thickness beyond which ELND should not be considered. We reviewed 169 patients with clinical stage I and II melanoma that was greater than or equal to 3.0 mm thick and who were treated at the University of Illinois Hospital, Chicago. Of 139 patients with clinical stage I disease, 117 underwent ELND. Five- and ten-year survival rates were 55.7% and 48.9%, respectively. Multifactorial analysis demonstrated that anatomical location, level, pathologic stage, and ulceration were the best predictors of survival. Thickness did not emerge as a significant variable. Our findings do not support basing treatment decisions, eg, ELND in this group of patients, solely on the thickness of the primary tumor. We continue to recommend ELND in patients with either intermediate or thick melanomas.
在临床I期黑色素瘤选择性淋巴结清扫术（ELND）的支持者中，对于肿瘤厚度是否存在上限，超过该厚度就不应考虑ELND存在争议。我们回顾了169例临床I期和II期、肿瘤厚度大于或等于3.0 mm且在芝加哥伊利诺伊大学医院接受治疗的黑色素瘤患者。139例临床I期疾病患者中，117例接受了ELND。5年和10年生存率分别为55.7%和48.9%。多因素分析表明，解剖位置、层次、病理分期和溃疡是生存的最佳预测因素。厚度并未成为显著变量。我们的研究结果不支持仅根据原发肿瘤的厚度来做出治疗决策，例如在这组患者中进行ELND。我们继续推荐对中度或厚黑色素瘤患者进行ELND。
