McBride C M, Smith J L, Brown B W
Cancer. 1981 Sep 15;48(6):1463-8. doi: 10.1002/1097-0142(19810915)48:6<1463::aid-cncr2820480631>3.0.co;2-z.
The pathologic material from 256 patients with malignant melanoma of the limb seen between 1955 and 1969 was reviewed to correlate the clinical course of the disease with the microstage, in an attempt to determine whether treatment factors affect the course of the disease. Rates of disease recurrence observed during the ten-year follow-up period were: Level II--19%, III--33%; IV--54% and V--94%, while for measured depths the recurrence rates were less than 0.5 mm--18%; 0.5 to 1 mm--26%; 1 to 1.5 mm--44%; 1.5 to 2 mm--49%; 2 to 3 mm--78% and greater than 3 mm--74%. For those patients with Level II melanomas, or Level III less than 1 mm, there was no difference in disease recurrence or survival, whether they were treated by wide local excision, with or without lymph node dissection, or by regional chemotherapy. For the more deeply invasive melanomas, rates of disease recurrence, survival and time to recurrence were all statistically better for those treated by regional therapy, confirming a treatment effect for malignant melanoma patients.
回顾了1955年至1969年间所见的256例肢体恶性黑色素瘤患者的病理资料，以将疾病的临床病程与微分期相关联，试图确定治疗因素是否影响疾病进程。在十年随访期内观察到的疾病复发率为：Ⅱ级——19%，Ⅲ级——33%；Ⅳ级——54%，Ⅴ级——94%，而对于测量深度，复发率分别为小于0.5mm——18%；0.5至1mm——26%；1至1.5mm——44%；1.5至2mm——49%；2至3mm——78%，大于3mm——74%。对于那些Ⅱ级黑色素瘤患者，或Ⅲ级且厚度小于1mm的患者，无论他们接受广泛局部切除治疗（有无淋巴结清扫）还是区域化疗，疾病复发率或生存率均无差异。对于浸润更深的黑色素瘤患者，接受区域治疗的患者在疾病复发率、生存率和复发时间方面在统计学上均表现更好，证实了对恶性黑色素瘤患者的治疗效果。
