Epstein E, Bragg A K
Cancer. 1980 Aug 15;46(4):818-21. doi: 10.1002/1097-0142(19800815)46:4<818::aid-cncr2820460429>3.0.co;2-j.
On the basis of a study of 193 patients with localized melanoma followed for 25 years, it appears that such tumors are curable, in about 75% of the cases, by surgical removal alone. Of the 41 patients who died from this tumor, 92% succumbed during the first decade and the rest during the next five years. There were no deaths due to melanoma after 15 years of observation. Prophylactic lymph node dissection on these localized cases improved the survival statistics, but this may have been due to the elimination from this series of those with microscopic nodal metastases. A hopeless prognosis is unjustified in patients with primary melanoma because approximately only 25% of the patients in this series succumbed to this tumor during the 25 years of observation. Therapy in such individuals should be conservative until the diagnosis has been established by histopathologic examination. This policy minimizes unnecessary multilation and morbidity in benign lesions. The diagnosis should be suspected early and established or eliminated at the earliest possible time.
基于对193例局限性黑色素瘤患者长达25年的随访研究，结果显示，此类肿瘤约75%的病例仅通过手术切除即可治愈。在41例死于该肿瘤的患者中，92%在头十年内死亡，其余在接下来的五年内死亡。观察15年后，无因黑色素瘤死亡的病例。对这些局限性病例进行预防性淋巴结清扫改善了生存统计数据，但这可能是由于该系列中排除了有微小淋巴结转移的患者。原发性黑色素瘤患者不应有绝望的预后，因为在本系列中，约只有25%的患者在25年的观察期内死于该肿瘤。在此类患者的诊断通过组织病理学检查确立之前，治疗应保守。该策略可将良性病变中不必要的致残和发病风险降至最低。应尽早怀疑诊断，并尽早确立或排除诊断。
