Lederman J S, Sober A J
J Dermatol Surg Oncol. 1986 Jul;12(7):697-9. doi: 10.1111/j.1524-4725.1986.tb01974.x.
502 patients with clinical stage I cutaneous melanoma were reviewed to determine if performing a wide excision (4-5 cm) at the time when the diagnosis of melanoma is suspected, improves the survival. Patients were divided into two groups based on initial biopsy type and thickness category. Group 1, wide excision; group 2, total excision with narrow margins, incisional, or punch biopsies. There was no evidence that patients who had had a diagnostic and therapeutic procedure (wide excision) as the initial approach had a better survival than those who had had another form of biopsy before definitive surgery. We cannot recommend excision with wide margins as the initial biopsy procedure for a lesion suspected to be melanoma before histologic verification, since it does not increase survival for melanoma and may result in unnecessary aggressive surgery in the case of a misdiagnosed benign lesion.
对502例临床I期皮肤黑色素瘤患者进行了回顾性研究，以确定在怀疑诊断为黑色素瘤时进行广泛切除（4 - 5厘米）是否能提高生存率。根据初始活检类型和厚度类别将患者分为两组。第1组，广泛切除；第2组，切缘狭窄的全切除、切开活检或钻孔活检。没有证据表明，以诊断性和治疗性手术（广泛切除）作为初始治疗方法的患者，其生存率比在确定性手术前进行其他形式活检的患者更高。在组织学验证之前，对于疑似黑色素瘤的病变我们不建议将宽切缘切除作为初始活检程序，因为它不会提高黑色素瘤患者的生存率，而且在误诊为良性病变的情况下可能导致不必要的激进手术。
