Peters A, Lippold A, Hundeiker M
Fachklinik Homheide an der Westfällschen Wilhelms-Universität, Münster.
Hautarzt. 1997 May;48(5):311-7. doi: 10.1007/s001050050588.
36 (3.5%) of 1015 patients who had ten or more years of follow-up after treatment of invasive malignant melanomas (stage I and II, UICC 1978) in Hornheide 1967-1984 developed late metastases. The mean disease-free interval was 12.5 years. These patients were younger (mean age of 45.8 years) compared to the age of all melanoma patients at the time of primary therapy. The rate of late relapses was 2.8% in women (20/705) and 5% in men (16/310). In melanomas located on the trunk or on the legs in male individuals, the relapse was twice as high as in females. The median tumor thickness in patients with late progression was 1.5 mm; in patients without relapse 1.2 mm. The well known association of tumor thickness with the risk of metastases disappeared after a 10 years disease-free interval. The frequency of metastases (3.5%) did not vary in different thickness classes from 0.76 mm to 3 mm or more. Melanomas with a Breslow thickness < 0.75 mm had a risk of only 1.4%. 23 patients (64%) developed distant, only 13 (36%) regional late metastases as first evidence of recurrent disease. The survival of these patients correlated neither to the duration of previous relapse-free follow up, nor to site of the primary lesion nor to sex. It correlated only to the site of metastases: 83% of all patients with distant late metastases had a remaining life time of 14 months or less, but patients with regional metastases survived more than 7 years in 69% of the cases. We have been unable to define risk factors for late metastases.
1967年至1984年在霍恩海德接受侵袭性恶性黑色素瘤（I期和II期，UICC 1978）治疗后有10年或更长时间随访的1015例患者中，36例（3.5%）发生了晚期转移。无病间期的中位数为12.5年。与初次治疗时所有黑色素瘤患者的年龄相比，这些患者更年轻（平均年龄45.8岁）。女性的晚期复发率为2.8%（20/705），男性为5%（16/310）。在男性患者中，位于躯干或腿部的黑色素瘤复发率是女性的两倍。晚期进展患者的肿瘤厚度中位数为1.5毫米；无复发患者为1.2毫米。在10年无病间期后，肿瘤厚度与转移风险之间的已知关联消失。在0.76毫米至3毫米或更厚的不同厚度类别中，转移频率（3.5%）没有变化。Breslow厚度<0.75毫米的黑色素瘤转移风险仅为1.4%。23例患者（64%）发生远处转移，仅13例（36%）发生区域晚期转移作为复发疾病的首发证据。这些患者的生存率既与先前无复发生存期的长短无关，也与原发灶部位和性别无关。它仅与转移部位相关：所有远处晚期转移患者中有83%的剩余生存期为14个月或更短，但区域转移患者在69%的病例中存活超过7年。我们无法确定晚期转移的危险因素。
