摘要
目的探讨足底皮肤恶性黑色素瘤的手术疗效.方法回顾性分析我院1998～2004年共收治的31例足底皮肤恶性黑色素瘤患者,均有病理学证实,采取手术、Ⅰ期腹股沟淋巴结清扫术为主的综合方式治疗足底皮肤恶性黑色素瘤.用Kaplan-Meier法统计生存率,用Log-rank检验模型对患者肿瘤大小、厚度、手术切除范围等影响因素进行分析.结果 31例足底皮肤恶性黑色素瘤患者至今生存22例,5年生存率为70%(22/31,P＝0.0366),无局部复发,Ⅰ期行腹股沟淋巴结清扫术28例,9例出现腹股沟淋巴结转移,4例出现全身多处转移,死亡9例.T<1.5mm,1.5mm<T<2.5mm,2.5mm<T<4.0mm,T>4.0mm,5年生存率分别是66.7%,63.64%,30%,0%.结论足底皮肤恶性黑色素瘤恶性程度高,易远处转移.综合方式治疗可降低转移率,使大部分患者的生存期得到延长.
Objective To study the clinical operative treatment of cutaneous malignant melanoma on foot. Methods Since 1998 to 2004, 3l patients with melanoma on foot were treated in our department by comprehensive treatment, individual operation, and first stage radical groin dissection. Their clinical materials and follow up results were retrospectively analyzed. Results 22 patients were survived. The appear ance and function of foot recovered well, the recurrence didn＇t appear in operative sites. The 5-year overall survival rates of 31 patients were 70%（22/31）. T〈1. 5mm, 1.5mm〈T〈2. 5mm, 2. 5mm〈T〈4. 0 mm,T〈4. 0mm were 66. 7%,63.64% ,30%, 0% respectively. Among them, nine patients died from systemic metastasis, regional groin lymph node metastasis appeared in nine patients, the other patients survived. Factors that might be related to survival , including tumor size, excising depth and range, were analyzed by Kaplan-Meier and Log rank method. Conclusion Patients with melanoma on foot had high distant metastasis rate. Distant metastasis is an important factor that affects the survival rate. It might be a key to reach satisfactory curative effect to thoroughly individual excise melanoma on foot in a certain range and depth.
出处
《肿瘤防治研究》
CAS
CSCD
北大核心
2005年第10期648-650,653,共4页
Cancer Research on Prevention and Treatment
关键词
恶性黑色素瘤
足部
手术治疗
生存率
Melanoma
Foot
Comprehensive operative treatment
Survival
