Gromet M A, Ominsky S H, Epstein W L, Blois M S
Cancer. 1979 Aug;44(2):776-84. doi: 10.1002/1097-0142(197908)44:2<776::aid-cncr2820440252>3.0.co;2-t.
Thirteen of 324 patients with malignant melanoma followed during a 24 month period experienced dissemination. The thorax was the initial site for relapse in 12, all of whom were asymptomatic. Ten gave no evidence of extrathoracic disease. Retrospective analysis of previous x-rays originally interpreted as negative revealed metastases in 33%. Life table analysis demonstrated a significantly longer survival for the subset with isolated intrathoracic metastases treated surgically than for their counterparts with metastases no longer amenable to surgery and treated by other modalities. We conclude that the thorax is the site of predilection for initial systemic relapse in malignant melanoma, that detection of early, surgically resectable metastases correlates with longer patient survival, and that routine chest roentgenography is inadequate in reliably uncovering such early disease. These data suggest the potential value of more vigorous radiographic surveillance (with either computed tomography or conventional full lung tomography) in patients at high risk for relapse.
在24个月的随访期内，324例恶性黑色素瘤患者中有13例出现了转移。胸部是12例患者复发的初始部位，所有这些患者均无症状。其中10例没有胸外疾病的证据。对先前最初被解读为阴性的x光片进行回顾性分析发现，33%存在转移。生命表分析表明，接受手术治疗的孤立性胸内转移亚组患者的生存期明显长于那些转移灶不再适合手术而接受其他治疗方式的患者。我们得出结论，胸部是恶性黑色素瘤初始全身复发的偏好部位，早期可手术切除转移灶的检测与患者更长的生存期相关，并且常规胸部x线摄影在可靠地发现此类早期疾病方面并不充分。这些数据表明，对于复发高危患者，更积极的影像学监测（计算机断层扫描或传统全肺断层扫描）具有潜在价值。
