四肢恶性黑色素瘤28例的治疗回顾分析

Retrospective analysis of 28 cases of limbs malignant melanoma

目的：讨论恶性黑色素瘤的治疗方法及预后。方法：回顾分析笔者科室2008年1月～2011年12月收治的28例四肢恶性黑色素瘤患者，其中男性13例，女性15例，年龄最大者68岁，年龄最小者25岁，平均年龄43岁，发生于上肢者10例，发生于下肢者18例。所有病例均经病理证实为恶性黑色素瘤。入院后未行手术治疗者先取活检，术中切口距病灶缘约1cm，病检结果证实为恶性黑色素瘤后即行扩大切除术。已行手术者行原切口缘扩大切除术，距原切口缘3～5cm，术后行放化疗。结果：28例患者术后切口均I期甲级愈合，术后随访2年，21例患者未出现病灶复发，生存质量良好。7例因肿瘤复发或转移死亡。结论：恶性黑色素瘤患者的治疗选择扩大切除，辅以术后放化疗是一种有效的方法。

Objective To evaluate the treatment and the prognosis of malignant melanoma Methods We retrospective analysis of 28 cases of limbs malignant melanoma whom were admission to our hospital between 2008- 2011,among them,male 13cases,and female 15cases.The oldest patient is 68 years old,but the youngest is 25 years old, the average age is 43.10 cases occurred in upper extremity,and 18 cases occurred in lower extremity.All cases were confirmed by pathology as malignant melanoma.If the patient was not performed surgery before admission,we take biopsy first, and intraoperative incision is about 1 cm from lesion margin,then we will perorm extended resection when pathology is malignant melanoma.If the patient have been performed surgery before admission, we will perorm extended resection and intraoperative incision is about 3- 5cm from lesion margin, followed by radiotherapy and chemotherapy. Results The incision in 28 patients were healing at grade one,after postoperative follow- up of 2 years,21 patients were cured and in good quality.7 cases died because of tumor recurrence or metastases. Conclusion Extended resection combined with chemotherapy and radiotherapy is an effective treatment method on malignant melanomachemotherapy.