[Treatment of stage I malignant melanoma]

In 259 patients with malignant melanoma of the skin referred here during 1973-1984, the median follow-up was 46 months. Of 182 with stage I disease, 97 (53.2%) were women and 85 men. Of these, 90.1% were Jews of European extraction and 8.2% were Jews of Asian-African extraction, while only 1.8% were non-Jews. 171 (94%) of the patients were treated by wide excision, with or without skin graft, as primary treatment, while 11 had limited local excision. In 16.4% the primary tumor was located on the upper limbs, in 34.6% the lower limbs, in 27.5% the trunk and in 19.2% the head and neck. 5-year survival was 70%. The 5-year actuarial survival was significantly influenced by: age (those under 50 had better survival, 79.5% vs 58.4%, p less than 0.05); by site of the primary lesion (88.5% for those of the upper limbs vs 59.4% for those of the lower limbs), p less than 0.01]; by depth of invasion as seen microscopically (81.2% for Clark I-II vs 52.8% for Clark IV-V, p less than 0.02); and by site of recurrence (43.4% if local vs 0 for distant, p less than 0.02).