皮肤黑色素瘤患者在2厘米半径内再次切除-足以局部肿瘤根治

S. Strashilov, A. Yordanov, Mariela Vasileva-Slaveva, A. Konsoulova
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摘要

恶性黑色素瘤是人体最恶性的肿瘤之一。肿瘤床的根治性再切除是其外科治疗的主要部分。我们的目的是验证这样一种假设,即从先前的原发肿瘤活检中向所有方向切除2厘米边缘的疤痕,为该疾病患者提供了充分的局部控制。材料和方法这是一项使用STROBE方法的前瞻性描述性研究,纳入了2012-2016年期间在保加利亚普列文医科大学Georgi Stranski大学医院整形、重建和美容外科诊断和治疗的所有151例皮肤恶性黑色素瘤患者。由于资料不足,21例病例在观察期内被遗漏。再次切除主要是在原肿瘤活检疤痕周围各方向2厘米范围内。结果在我们的单一大型中心诊断和治疗的所有130例恶性皮肤黑色素瘤患者的数据进行前瞻性登记和分析。其中男性67例,女性63例,诊断时平均年龄61.6岁(范围:17-91岁)。在2厘米边缘的再切除中,我们发现只有1例(0.77%)患者在再切除的皮瓣中有组织学证实的残留肿瘤。局部复发13例(10%)。结论再次切除2 cm切缘足以在不影响肿瘤生存的情况下实现局部手术根治性治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Re-excision within a radius of 2 cm in patients with melanoma of the skin – sufficient for local oncological radicalness
Introduction Malignant melanoma is one of the most malignant tumours in the human body. Radical re-excision of the tumour bed is a principal part of its surgical treatment. We aim to test the hypothesis that the re-excision with a 2 cm margin in all directions to the scar from the previous biopsy of the primary tumour provides sufficient local control in patients with this disease. Material and methods This is a prospective descriptive study using STROBE methods, including all 151 patients with malignant melanoma of the skin, diagnosed and treated at the Department of Plastic, Reconstructive, and Aesthetic Surgery, Dr Georgi Stranski University Hospital, Medical University of Pleven, Bulgaria, in the period 2012–2016. Twenty-one cases were omitted from the study during the observation period due to lack of sufficient data. The re-excision was mainly within 2 cm margins in all directions to the scar from the previous biopsy of the primary tumour. Results Data of all 130 patients with malignant skin melanoma, diagnosed and treated at our single large centre, were prospectively registered and analysed. These were 67 male and 63 female patients with a mean age at diagnosis of 61.6 years (range: 17–91 years). Using the re-excision within 2 cm margins, we identified only 1 (0.77%) patient with a histologically confirmed residual tumour in the re-excised flap. Local recurrence was observed in 13 (10%) patients. Conclusions Re-excision with a 2 cm margin is sufficient to achieve local surgical radicalness in the treatment of this disease without compromising oncological survival.
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