Schraffordt Koops H, Oldhoff J, van der Ploeg E, Vermey A, Eibergen R, Beekhuis H
Cancer. 1977 Jan;39(1):27-33. doi: 10.1002/1097-0142(197701)39:1<27::aid-cncr2820390106>3.0.co;2-y.
This paper reviews the changing concepts in the treatment of patients with malignant melanoma localized on the arm or leg. In addition to conventional surgical treatment, isolated regional perfusion of the extremities is discussed. An evaluation is presented of clinical and histological criteria applied to determine indications for conventional surgical treatment and for perfusion. It is maintained that isolated regional perfusion of arm or leg should be performed when the primary tumor meets one of the following criteria: (1) depth of tumor invasion beyond the papillary layer (Clark levels III, IV and V); (2) vascular invasion; (3) tumor diameter exceeding 1 cm; (4) ulceration. If none of these four criteria applies, conventional surgical treatment alone has proved to give very good results.
本文综述了手臂或腿部局限性恶性黑色素瘤患者治疗观念的变化。除了传统的手术治疗外，还讨论了肢体的孤立区域灌注。本文对用于确定传统手术治疗和灌注适应证的临床及组织学标准进行了评估。认为当原发性肿瘤符合以下标准之一时，应进行手臂或腿部的孤立区域灌注：（1）肿瘤浸润深度超过乳头层（克拉克分级III、IV和V级）；（2）血管浸润；（3）肿瘤直径超过1cm；（4）溃疡形成。如果这四条标准均不适用，仅采用传统手术治疗已证明能取得非常好的效果。
