Shafir R, Hiss J, Tsur H, Bubis J J
Cancer. 1982 Aug 15;50(4):817-9. doi: 10.1002/1097-0142(19820815)50:4<817::aid-cncr2820500434>3.0.co;2-v.
In the past few years a change has been noticed in the behavior of cutaneous malignant melanoma, with higher cure and survival rates. A retrospective review of all cases of primary cutaneous malignant melanoma during the years 1970-1979 in Chaim Sheba Medical Center reveals a possible explanation for this. The microscopic findings were reevaluated, diagnosis confirmed, and thickness of the tumor measured in millimeters. The number of cases diagnosed rose from eight in 1970 to 45 in 1979. A constant rise in number of thin melanomas (less than 0.75 mm in depth) was noticed. The percentage of thin melanoma rose from 11.1% of all melanomas in 1970 to 57.7% in 1979. Greater public and medical awareness of the danger of pigmented cutaneous lesions has probably triggered an earlier diagnosis of melanoma. Each suspected lesion is completely excised with a 1-cm free margin. No further excision is undertaken if a thin melanoma is diagnosed (excluding the more malignant regressing melanoma) on frozen section. Of the patients seen in 1979, 57% were spared wide excision and general anesthesia.
在过去几年里，人们注意到皮肤恶性黑色素瘤的行为发生了变化，治愈率和生存率有所提高。对1970年至1979年期间哈伊姆·谢巴医疗中心所有原发性皮肤恶性黑色素瘤病例的回顾性研究揭示了其中的一个可能原因。对显微镜检查结果进行了重新评估，确诊了诊断，并以毫米为单位测量了肿瘤的厚度。确诊病例数从1970年的8例增加到1979年的45例。薄黑色素瘤（深度小于0.75毫米）的数量持续上升。薄黑色素瘤在所有黑色素瘤中的比例从1970年的11.1%上升到1979年的57.7%。公众和医学界对色素沉着性皮肤病变危险性的认识提高，可能促使黑色素瘤的诊断提前。每个疑似病变都被完整切除，切缘有1厘米的安全距离。如果在冰冻切片上诊断为薄黑色素瘤（不包括更恶性的消退性黑色素瘤），则不再进行进一步切除。在1979年就诊的患者中，57%的患者避免了广泛切除和全身麻醉。
