Rizk S N, Ryan J J
Department of Surgery, USD School of Medicine, Sioux Falls.
S D J Med. 1994 Jul;47(7):217-21.
Management of melanoma is still based almost exclusively on the thickness of the primary lesion. Recent studies demonstrated that a surgical margin of 1 cm is adequate for most thin melanomas (1 mm or less in Breslow thickness), whereas thicker lesions may be removed with a surgical margin of 2 to 3 cm without adversely affecting the rate of local recurrence or patient survival. The value of prophylactic lymph node dissection in the management of primary melanoma is still debated. The role of chemotherapy and immunologic modalities in the treatment of this type of neoplasm requires better understanding and awaits the results of randomized, prospective studies.
黑色素瘤的治疗几乎仍然完全基于原发灶的厚度。最近的研究表明，对于大多数薄型黑色素瘤（Breslow厚度为1mm或更薄），1cm的手术切缘是足够的，而对于较厚的病灶，可以采用2至3cm的手术切缘切除，且不会对局部复发率或患者生存率产生不利影响。预防性淋巴结清扫在原发性黑色素瘤治疗中的价值仍存在争议。化疗和免疫治疗方式在这类肿瘤治疗中的作用需要更好地理解，并且有待随机前瞻性研究的结果。
