四肢黑色素瘤不同手术方式的比较

Compare Different Surgical Treatment on Limbs Melanoma

目的比较早期黑色素瘤行截肢或截指手术与病灶扩大切除术两者的疗效。方法收治四肢黑色素瘤患者32例,手术治疗29例。行截指或截肢术15例,应用病灶扩大切除加皮瓣转移覆盖术或植皮术14例,将其分为截肢组和保肢组。结果 29例获得随访,随访时间30～60月,平均42月,截肢组15例中有2例复发,保肢组14例中有5例复发,截肢组与保肢组5年生存率分别为62.5%与57.1%。生存曲线Log rank检验比较(P=0.318),显示两组间差异无统计学意义。结论早期黑色素瘤行截肢或截指手术相对于保守的病灶扩大切除术可以降低黑色素瘤的局部复发率,但两者术后5年生存率以及生存时间并无明显差异。

To compare the curative effect of amputation of the toe or amputation with extended resection on the surgical treatment of primary melanoma.Methods Twenty-nine patients were treated with surgical treatment.Fifteen of the patients defined as group of amputation,were treated with amputation of the toe or amputation,and the others defined as the control group were treated with extended resection and flap replacement or dissociate plant skin.Result All patients were followed up for 30~60 months with an average of 42 months.There were 2 cases recurred in amputation group,5 cases did in control group.The 5-year survival rate of amputation group and control group was 62.5% and 57.1% respectively,and there was no difference in Log-rank survival curve.Conclusion Compared with extended resection,amputation of the toe or amputation could decrease the local recurrence of primary melanoma.While there were no differences in the 5-year survival rate and survival time between these two groups.