Siminovitch J M, Bergfeld W, Dinner M
Ann Plast Surg. 1980 Dec;5(6):432-5.
Since few cases of exophytic malignant melanoma have been reported, their nature, history, and prognosis have been uncertain and controversial. We report 26 cases followed at the Cleveland Clinic from 1969 to 1975. Twenty men and 6 women ranging in age from 19 to 65 years were followed. There were 16 deaths, 3 patients are alive with lymph node metastases, and 3 patients are alive with distant metastases, for a 2-year disease-free survival of 15% and 5-year survival of 33%. All patients had lesions of either Clark level III, IV, or V with no correlation to survival. All lesions were 2 mm or more in thickness. A 44% disease-free survival was found for lesions 2 to 3 mm in thickness and no disease-free survival for lesions thicker than 3 mm. Our findings support the concept that exophytic malignant melanomas have increased malignant potential. We believe all malignant melanomas should be classified according to both Clark levels and Breslow's micrometer thickness measurements.
由于外生性恶性黑色素瘤的病例报告较少，其性质、病程及预后一直不明确且存在争议。我们报告了1969年至1975年在克利夫兰诊所随访的26例病例。随访了年龄在19岁至65岁之间的20名男性和6名女性。有16例死亡，3例患者存活但有淋巴结转移，3例患者存活但有远处转移，2年无病生存率为15%，5年生存率为33%。所有患者的病变均为克拉克三级、四级或五级，与生存率无关。所有病变厚度均在2毫米或以上。厚度为2至3毫米的病变无病生存率为44%，厚度超过3毫米的病变无病生存率为零。我们的研究结果支持外生性恶性黑色素瘤具有更高恶性潜能这一概念。我们认为所有恶性黑色素瘤都应根据克拉克分级和布雷斯洛微米厚度测量进行分类。
