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Arthur W Cowman¹, Kristel Lourdault¹, Douglas Hanes²

¹Saint John's Cancer Institute, Santa Monica, California, USA.

Cancer medicine

|February 20, 2025

概括

对于厚黑色素瘤,增加瘤厚度和阳性淋巴结会使存活率恶化. 哨戒淋巴结活检对分期至关重要,但完整的淋巴结剖析在阳性哨戒淋巴结活检后没有生存益处.

科学领域:

在瘤学瘤学.
手术瘤学手术瘤学
皮肤病学皮肤病学

背景情况:

结节阴性疾病的厚黑色素瘤 (T4,>4mm) 具有可变的外科治疗方法.
这些患者的整体生存 (OS) 因素需要进一步评估,特别是在初级瘤和节点盆地手术方面.

研究的目的:

评估影响厚黑色素瘤和临床结节负性疾病患者整体存活时间 (OS) 的因素.
为了比较不同节点评估策略 (哨兵淋巴结活检,选择性淋巴结切除术,没有节点评估) 对OS的影响.

主要方法:

从国家癌症数据库 (2012-2017) 分析了4332名患有厚黑色素瘤的患者.
分层为哨兵淋巴结活检 (SLNB),选择性淋巴结切除术 (ELND) 或没有结节评估 (NNE) 组.
卡普兰-梅尔和多变量考克斯回归分析来比较OS.

主要成果:

增加Breslow厚度,,淋巴血管入侵和阳性SLN (+SLN) 与更糟糕的OS有关.
五年后的OS最高的是SLNB (67.1%),其次是ELND (57.9%) 和NNE (46.8%).
+SLN后的完整淋巴结解剖 (CLND) 与观察相比没有改善OS.

结论:

的厚度和节点评估是厚黑色素瘤OS的关键预后因素.
在厚黑色素瘤患者中,SLNB对于准确的分期至关重要.
对于具有阳性SLN的厚黑色素瘤患者来说,CLND没有提供OS益处.

关键词:

没有NCDBB,没有NCDB.哨兵淋巴结活组织检查外科手术的管理.幸存率幸存率生存率厚型黑色素瘤是什么意思

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