Sutherland C M, Mather F J, Muchmore J H, Carter R D, Reed R J, Krementz E T
Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112.
Am J Surg. 1993 Jul;166(1):64-7. doi: 10.1016/s0002-9610(05)80586-0.
Between 1958 and 1990, 82 patients with acral lentiginous melanoma were treated by the Tulane Surgical Service with regional perfusion, excision of lesion, and lymph node dissection. The patient group comprised 27 white men, 29 white women, 18 black men, and 8 black women, with an average age of 61 years. More foot lesions than hand lesions were reported, and all the lack men had foot lesions. In stage I patients, overall 5-year survival rates were 65% at 5 years and 44% at 10 years, with differences by race and gender. The black men did poorest, with a 13% 10-year survival rate. Survival rates were worse with increasing disease stage when calculated using univariate analysis. The 5-year survival rate of all patients with stage III and stage IV disease was 26%. A multivariate analysis was performed in 78 of 82 patients in whom all variables of Clark's level, age, race, stage, and sex were known. A strong relationship was observed between decreasing survival time and increasing Clark's level, with stage of marginal significance. In a multivariate analysis of patients with stage I disease, an increasing level of invasion was found to be significant, with a trend for a relationship to thickness. A trend toward decreased survival time was observed in men and blacks.
1958年至1990年间，杜兰大学外科治疗组对82例肢端雀斑样痣黑素瘤患者进行了区域灌注、病灶切除及淋巴结清扫治疗。患者组包括27名白人男性、29名白人女性、18名黑人男性和8名黑人女性，平均年龄61岁。报告的足部病灶多于手部病灶，所有黑人男性均有足部病灶。I期患者的5年总生存率5年时为65%，10年时为44%，存在种族和性别的差异。黑人男性情况最差，10年生存率为13%。单因素分析显示，生存率随疾病分期增加而降低。III期和IV期所有患者的5年生存率为26%。对82例患者中的78例进行了多因素分析，这些患者的Clark分级、年龄、种族、分期和性别等所有变量均已知。观察到生存时间缩短与Clark分级增加之间存在密切关系，分期的影响不显著。在对I期疾病患者的多因素分析中，发现浸润程度增加具有显著意义，且与厚度存在相关趋势。在男性和黑人中观察到生存时间缩短的趋势。
