Shumate C R, Urist M M, Maddox W A
Department of Surgery, University of Alabama at Birmingham, USA.
Ann Surg. 1995 May;221(5):566-9; discussion 569-71. doi: 10.1097/00000658-199505000-00014.
The authors determined the roles of the physician and the patient in melanoma recurrence detection.
The University of Alabama Melanoma Registry, consisting of 1475 patients surgically treated for cutaneous melanoma from 1958 to 1984, was searched to find 195 evaluable cases of melanoma recurrence. Patients were grouped by the type of return visit. Group I returned on a previously determined date, whereas group II returned before the scheduled visit.
Symptoms of recurrence were present in 90% of group I patients and 93% of group II and correlated with the site of recurrence in more than two thirds of cases. Recurrence sites were local, regional, and distant in 35%, 31%, and 29% of group I, respectively, and 42%, 25%, and 29% of group II. The median interval to recurrence was 24.2 months in group I and 37.7 months in group II (p = 0.059). Median overall survival was 57 months in group I and 62 months in Group II (p = 0.210).
Symptoms are present in 90% of the patients with recurrent melanoma and accurately predict the site of recurrence. Overall survival is not affected by the type of patient return visit.
作者确定了医生和患者在黑色素瘤复发检测中的作用。
对阿拉巴马大学黑色素瘤登记处进行检索，该登记处包含1958年至1984年接受皮肤黑色素瘤手术治疗的1475例患者，以找出195例可评估的黑色素瘤复发病例。患者按复诊类型分组。第一组在预先确定的日期复诊，而第二组在预定复诊日期之前复诊。
第一组90%的患者和第二组93%的患者出现复发症状，且在超过三分之二的病例中与复发部位相关。第一组复发部位为局部、区域和远处的分别占35%、31%和29%，第二组分别为42%、25%和29%。第一组复发的中位间隔时间为24.2个月，第二组为37.7个月（p = 0.059）。第一组的中位总生存期为57个月，第二组为62个月（p = 0.210）。
90%的复发性黑色素瘤患者出现症状，且能准确预测复发部位。患者复诊类型不影响总生存期。
