Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities
Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities
复制标题
下肢皮肤黑色素瘤 I 期延迟区域淋巴结清扫术
作者：
Umberto Veronesi;J. Adamus;D. Bandiera;I. Brennhovd;E. Cáceres;N. Cascinelli;F. Claudio;R. Ikonopisov;V. V. Javorski;S. Kirov;A. Kułakowski;J. Lacour;F. Lejeune;Z. Mechl;A. Morabito;I. Rodé;S. Sergeev;E. Slooten;K. Szczygieł;N. Trapeznikov;R. I. Wagner
报告了世界卫生组织黑色素瘤诊断和治疗方法评估合作中心进行的一项前瞻性随机临床试验的结果。 553 名四肢受影响的 I 期患者进入了研究； 267 例接受了广泛切除和立即淋巴结清扫，286 例在检测到临床阳性淋巴结时进行了广泛切除和淋巴结清扫。两个治疗组的生存曲线可以叠加。没有任何患者亚群从立即淋巴结清扫中受益。作者得出的结论是，如果患者每三个月检查一次，延迟淋巴结清扫术与 I 期四肢黑色素瘤的立即清扫术一样有效。如果不能保证每季度随访一次，建议立即进行淋巴结清扫，至少对于厚度超过 2 毫米的黑色素瘤是这样。
Results of a prospective randomized clinical trial conducted by the WHO Collaborating Centers for the Evaluation of Methods of Diagnosis and Treatment of Melanoma are reported. Five‐hundred‐fifty‐three Stage I patients whose limbs were affected entered the study; 267 were submitted to wide excision and immediate node dissection and 286 had wide excision and node dissection at the time clinically positive nodes were detected. Survival curves of the two treatment groups could be superimposed. No subsets of patients benefitted from immediate node dissection. The authors conclude that delayed node dissection is as effective as the immediate dissection in Stage I melanoma of the extremities if the patient can be checked every three months. If the quarterly follow‐up is not guaranteed, immediate node dissection is advisable, at least for melanomas thicker than 2 mm.