Overett T K, Shiu M H
Cancer. 1985 Sep 1;56(5):1222-30. doi: 10.1002/1097-0142(19850901)56:5<1222::aid-cncr2820560544>3.0.co;2-a.
A retrospective study was made of the surgical treatment of distant metastases from melanoma in 143 patients. The determinants of survival benefit were: (1) successful complete resection of all clinical disease; (2) single versus multiple metastatic site; and (3) anatomic location of disease. Complete resection was achieved with single- and multiple-site lesions in 67% and 31% of the patients, respectively, yielding corresponding 5-year survival rates of 33% and 9%, respectively. Incomplete resection yielded little survival benefit. Soft tissue and extraregional nodal lesions were completely resectable in 70%, whereas pulmonary, extrahepatic abdominal visceral, and osseous lesions were in 40% of the patients, resulting in similar 5-year survival rates of 17% to 22%. The operative mortality rate was 1.4% (2/143). Unsuccessful resection frequently led to very long hospitalization periods for complications and disease, with some patients spending more than 50% of their remaining survival time in the hospital. These observations suggest that, with proper selection of patients, guided by these determinants, surgical resection can offer a reasonable expectation of prolonged survival.
对143例黑色素瘤远处转移患者的外科治疗进行了回顾性研究。生存获益的决定因素包括：（1）成功完全切除所有临床病灶；（2）单发性与多发性转移部位；（3）病灶的解剖位置。单发性和多发性病灶患者分别有67%和31%实现了完全切除，其5年生存率分别为33%和9%。不完全切除几乎没有生存获益。软组织和区域外淋巴结病灶70%可完全切除，而肺部、肝外腹部脏器和骨病灶患者中40%可完全切除，5年生存率相似，为17%至22%。手术死亡率为1.4%（2/143）。切除失败常常导致因并发症和疾病而住院时间极长，一些患者在医院度过了剩余生存期的50%以上。这些观察结果表明，在这些决定因素的指导下，合理选择患者，手术切除可带来延长生存期的合理期望。
