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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Malignant melanoma of the head and neck: effect of treatment on survival.
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Malignant melanoma of the head and neck: effect of treatment on survival.

机译：头颈部恶性黑色素瘤：治疗对生存的影响。

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This study compared outcomes for intermediate-thickness (1.5 to 3.99 mm) head and neck melanomas treated with or without elective lymph node dissection (ELND). The records of all head and neck melanomas treated at Virginia Mason Medical Center from 1974 through 1995 were reviewed and analyzed for outcome by stage and elective or therapeutic lymph node dissection. One hundred seventy-four patients with head and neck melanomas were treated in the study period, of which only 25% had intermediate-thickness lesions. Of 38 clinically node-negative patients with intermediate-thickness lesions followed more than 3 years, 10 underwent ELND, yielding two positive dissections (20%). The rate of distant metastases and the mortality rate were 44% and 35% lower in patients undergoing ELND compared with stage II patients who did not undergo ELND, but the difference did not achieve statistical significance (P = 0.12 and 0.21, respectively). The role of ELND in head and neck melanoma is uncertain. This retrospective study is limited by the small number of intermediate-thickness lesions, yet there appears to be a survival advantage to ELND in head and neck melanoma, even in negative dissections. Conventional histologic stains miss micrometastases detected by immunohistological and polymerase chain techniques. Removal of such micrometastases may explain the improved outcome. A multicenter prospective trial in head and neck melanomas, incorporating the latest techniques of sentinel node biopsy and immunohistological staining of node specimens, is needed to clarify definitive therapy for this increasingly common diagnosis.
机译：这项研究比较了接受或不接受选择性淋巴结清扫术（ELND）治疗的中厚（1.5至3.99 mm）头颈部黑素瘤的结局。回顾并分析了1974年至1995年在弗吉尼亚梅森医疗中心治疗的所有头颈部黑素瘤的记录，并按阶段，选择性或治疗性淋巴结清扫对其结果进行了分析。在研究期间共治疗了174例头颈部黑素瘤患者，其中只有25％的患者具有中厚皮损。在38例中度以上病变的临床淋巴结阴性患者中，进行了3​​年以上的随访，其中10例接受了ELND，产生了两个阳性解剖（20％）。与未接受ELND的II期患者相比，接受ELND的患者远处转移率和死亡率分别降低了44％和35％，但差异无统计学意义（分别为P = 0.12和0.21）。 ELND在头颈部黑素瘤中的作用尚不确定。这项回顾性研究受到少数中等厚度病变的限制，但即使在阴性解剖中，ELND在头颈部黑素瘤中似乎也具有生存优势。传统的组织学染色错过了通过免疫组织学和聚合酶链技术检测到的微转移。去除此类微转移可解释改善的结局。需要一项针对头颈部黑素瘤的多中心前瞻性试验，并结合前哨淋巴结活检和淋巴结标本的免疫组织学染色的最新技术，以阐明针对这种日益普遍的诊断的明确治疗方法。

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