Schmoeckel C, Braun-Falco O
Arch Dermatol. 1978 Jun;114(6):871-3.
A retrospective study was undertaken of 146 surgically treated subjects with primary cutaneous melanoma of which 73 were disease-free for five to nine years and 73 developed later metastases. A prognostic factor was south to determine patients with poor prognoses. The best overall method was shown to be the evaluation of the prognostic index defined as the product of tumor thickness and the number of mitoses per square millimeter. However, for establishing a group of patients with no incidence of metastases, the mitotic rate proved to be as good a factor as the prognostic index and better than tumor thickness or levels of invasion. The application of this prognostic index seems therefore to be useful in selecting for further treatment stage I melanoma patients with poor prognoses, eg, prophylatic lymph node dissection and immunochemotherapy.
对146例接受手术治疗的原发性皮肤黑色素瘤患者进行了一项回顾性研究，其中73例无病生存5至9年，73例后来发生转移。目的是确定一个预后因素，以判断预后不良的患者。结果表明，最佳的总体方法是评估预后指数，该指数定义为肿瘤厚度与每平方毫米有丝分裂数的乘积。然而，对于确定一组无转移发生的患者，有丝分裂率被证明是与预后指数一样好的因素，且优于肿瘤厚度或浸润水平。因此，这种预后指数的应用似乎有助于选择预后不良的I期黑色素瘤患者进行进一步治疗，例如预防性淋巴结清扫和免疫化疗。
