A prospective randomized study of the efficacy of routine elective lymphadenectomy in management of malignant melanoma. Preliminary results
A prospective randomized study of the efficacy of routine elective lymphadenectomy in management of malignant melanoma. Preliminary results
复制标题
一项关于常规选择性淋巴结切除术治疗恶性黑色素瘤疗效的前瞻性随机研究。
作者：
F. Sim;W. Taylor;J. Ivins;D. Pritchard;E. Soule
为了确定在局限性(I期)黑色素瘤病例中，立即或延迟淋巴清扫是否比不清扫更有益，我们在1972年进行了一项前瞻性随机研究。有中线主干病变的患者以及病变直接位于结节支配区的患者被排除在外。此外，由于转移风险低，方案被更改为排除2级病变。在所研究的173名患者中，63名患者被随机分为不行淋巴结清扫组，56例延期(3个月)清扫组，54例立即清扫组。在生存时间或转移间隔方面，这些方案与其他方案均无显著差异。在110例接受择期淋巴结清扫的患者中，103例无淋巴结受累。我们的初步结论是，选择性结节清扫术不利于黑色素瘤的治疗。然而，患者的年龄(>；60岁)和黑色素瘤的侵袭性(4级或5级)和厚度(>；1.5 mm)显著促进了疾病的进展。
To determine whether immediate or delayed lymphadenectomy is more beneficial than none in cases of localized (stage I) melanoma, we undertook in 1972 a prospective randomized study. Patients with midline trunk lesions were excluded as well as patients with lesions situated directly over the node‐bearing area. In addition, because of the low risk of metastasis, the protocol was changed to exclude level 2 lesions. Of the 173 patients studied, 63 were randomized to no lymphadenectomy, 56 to delayed (3 months) lymphadenectomy, and 54 to immediate lymphadenectomy. None of these regimens differed significantly from the others in its effect on length of survival or interval to metastasis. And of the 110 patients who underwent elective lymphadenectomy, 103 were without nodal involvement. Our preliminary conclusion is that elective node dissection is not beneficial in management of melanoma. However, disease progression was advanced significantly by age of the patient (>60 years) and by invasiveness (level 4 or 5) and thickness (>1.5 mm) of the melanoma.