Sober A J
Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston 02114.
Semin Surg Oncol. 1993 May-Jun;9(3):194-7.
The inefficacy of treatments for advanced melanoma have shifted the focus toward the recognition of early melanoma which is associated with a much more favorable outcome. In January 1992 the National Institutes of Health (NIH) held a Consensus Conference to establish definitions and therapeutic recommendations for the management of early melanoma. Early melanoma was defined as either in situ or invasive melanoma < 1 mm in depth. Surgical margins of 0.5 cm for in situ melanoma and 1 cm for invasive melanoma < or = 1 mm thick were recommended. The pathology reports should include as a minimum the diagnosis of melanoma, the maximum tumor thickness, and the status of the margins. Elective nodal dissection as well as high-tech radiologic procedures were not recommended. Follow-up of patients for the development of second primaries and of family members who may be at increased risk for melanoma was also recommended. Public education programs were suggested to inform the public of the increasing melanoma risk and improved survival through early detection.
晚期黑色素瘤治疗方法的无效性已将关注点转向早期黑色素瘤的识别，早期黑色素瘤的预后要乐观得多。1992年1月，美国国立卫生研究院（NIH）召开了一次共识会议，以确立早期黑色素瘤管理的定义和治疗建议。早期黑色素瘤被定义为原位黑色素瘤或深度小于1毫米的浸润性黑色素瘤。对于原位黑色素瘤，建议手术切缘为0.5厘米；对于厚度小于或等于1毫米的浸润性黑色素瘤，建议手术切缘为1厘米。病理报告应至少包括黑色素瘤的诊断、肿瘤最大厚度以及切缘情况。不建议进行选择性淋巴结清扫以及高科技放射学检查。还建议对患者进行随访，观察是否出现第二原发性肿瘤，并对黑色素瘤风险可能增加的家庭成员进行随访。建议开展公众教育项目，让公众了解黑色素瘤风险的增加以及通过早期检测可提高生存率。
