Choroidal Melanoma: Enucleation or Observation? A New Approach
Choroidal Melanoma: Enucleation or Observation? A New Approach
复制标题
脉络膜黑色素瘤：摘除还是观察？
DOI：
10.1001/archopht.1980.01020030073002
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发表时间：
1980
影响因子：
--
通讯作者：
Hennie A. van Peperzeel
中科院分区：
文献类型：
--
作者：
W. A. Manschot;Hennie A. van Peperzeel
•应用关于恶性肿瘤生长速度的知识对脉络膜黑色素瘤的研究表明：(1)由于葡萄膜黑色素瘤的生长速度普遍太低，摘除后2年内的死亡病例只有例外可能是由于肿瘤细胞在摘除过程中播散所致；(2)去核与转移死亡的表面关系实际上是原发肿瘤诊断与转移死亡的时间关系；(3)原发肿瘤及其转移灶的同时诊断很少；(4)从去核到转移死亡的时间间隔较长，可以解释为转移的生长速度较低。早期去核，尤其是小的黑色素瘤，是必须的，因为它可以防止肿瘤细胞（进一步）扩散。术前两剂400拉德的局部放疗可使约90%的原代细胞失活，并在很大程度上防止可能的医源性传播。
• Application of the knowledge of growth rate of malignant neoplasms on choroidal melanomas shows that (1) fatalities within two years after enucleation only exceptionally can be due to dissemination of tumor cells during enucleation because the growth rate of uveal melanomas generally is far too low; (2) the apparent relationship between enucleation and death by metastasis actually is a relationship in time between diagnosis of the primary tumor and death by metastasis; (3) simultaneous diagnosis of the primary tumor and its metastases rarely is possible; (4) long intervals between enucleation and death by metastasis are explained by a low growth rate of metastases. Early enucleation, especially of small melanomas, is obligatory, because it prevents (further) dissemination of tumor cells. Preoperative local radiotherapy of two doses of 400 rads each will devitalize about 90% of the primary cells and largely will prevent possible iatrogenic dissemination.