Roses D F, Harris M N, Gumport S L
Arch Surg. 1981 Mar;116(3):315-7. doi: 10.1001/archsurg.1981.01380150043011.
A group of 525 patients with primary cutaneous malignant melanoma of the trunk was treated by a uniform surgical approach that included regional lymph node dissection for selected patients; 266 (50.6%) had regional lymph node dissections in addition to wide and deep excision, all with primary lesions extending below the superficial papillary dermis. Of 171 patients treated over five years ago, 130 had histologically negative nodes; 94 (72%) are alive with no evidence of disease (NED). Of 41 with histologically positive nodes, 12 (29%) are alive with NED. A comparison of the 21 patients with clinically occult micrometastases shows eight (38%) alive with NED, whereas four of 20 (20%) with clinically demonstrable as well as histologically proven nodal metastases are alive with NED. Though there may be a modest benefit to lymph node dissection for microscopic rather than gross nodal metastases for invasive melanoma of the trunk, for most such patients melanoma in regional nodes indicates the presence of systemic metastatic disease.
一组525例躯干原发性皮肤恶性黑色素瘤患者采用统一的手术方法治疗，该方法包括对部分患者进行区域淋巴结清扫；266例（50.6%）除广泛深部切除外还进行了区域淋巴结清扫，所有患者的原发性病变均延伸至浅表乳头真皮以下。在5年前接受治疗的171例患者中，130例组织学检查淋巴结阴性；94例（72%）存活且无疾病证据（NED）。在41例组织学检查淋巴结阳性的患者中，12例（29%）存活且无疾病证据。对21例临床隐匿性微转移患者与20例临床可证实且组织学证实有淋巴结转移患者进行比较，前者有8例（38%）存活且无疾病证据，而后者有4例（20%）存活且无疾病证据。虽然对于躯干浸润性黑色素瘤，淋巴结清扫对微小而非大体淋巴结转移可能有一定益处，但对于大多数此类患者，区域淋巴结中的黑色素瘤表明存在全身转移性疾病。
