Beller U, Demopoulos R I, Beckman E M
J Reprod Med. 1986 May;31(5):315-9.
A retrospective study was done on 14 patients with vulvar and vaginal melanoma treated at the New York University Medical Center from 1972 through 1984. Pathologic evaluation included a measurement of tumor volume, tumor thickness, growth pattern and cell type. The most common morphologic appearance was a superficial spreading growth pattern with a nevoid cell type, which seemed to correlate with a favorable outcome. Nodular growth pattern with an epithelioid cell type was less common and associated with a poorer prognosis and inguinal lymph node metastases. No patient had deep pelvic node metastases. Tumor thickness, as measured with Breslow's method, was inversely related to survival, as previously reported. We were able to define a low-risk group of patients, with tumor volume under 100 mm3. It appears that tumor volume, in addition to thickness and growth pattern, can contribute to the evaluation of vulvar melanoma. Evaluation of our findings in conjunction with those in the literature on cutaneous and vulvar melanomas led us to question the routine management of these lesions with radical vulvectomy plus inguinal and pelvic lymph node dissection.
对1972年至1984年在纽约大学医学中心接受治疗的14例外阴和阴道黑色素瘤患者进行了一项回顾性研究。病理评估包括测量肿瘤体积、肿瘤厚度、生长模式和细胞类型。最常见的形态学表现是浅表扩散生长模式伴痣样细胞类型，这似乎与良好的预后相关。结节状生长模式伴上皮样细胞类型较少见，与较差的预后和腹股沟淋巴结转移相关。没有患者有盆腔深部淋巴结转移。如先前报道，用布雷斯洛方法测量的肿瘤厚度与生存率呈负相关。我们能够确定一组低风险患者，其肿瘤体积小于100立方毫米。看来，除了厚度和生长模式外，肿瘤体积也有助于对外阴黑色素瘤进行评估。将我们的研究结果与有关皮肤和外阴黑色素瘤的文献中的结果相结合进行评估，使我们对这些病变采用根治性外阴切除术加腹股沟和盆腔淋巴结清扫术的常规治疗方法产生了质疑。
