皮肤黑色素瘤的1厘米与2厘米切割边缘的比较:系统性审查和元分析
Darya Pospyelova1, Isabel Bunola-Hadfield2, Martha F De La Cruz Monroy3
1General Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, GBR.
Cureus
|June 26, 2025
概括
对于中等到厚度的黑色素瘤,1厘米的外科切除边缘与2厘米的边缘一样安全. 这一发现减少了复杂重建的需要,改善了黑色素瘤治疗患者的结果.
科学领域:
- 皮肤病学 皮肤病学
- 手术瘤学手术瘤学
- 基于证据的医学基于证据的医学.
背景情况:
- 宽局部切除术是局部皮肤黑色素瘤的标准手术治疗方法.
- 对于中等到厚度黑色素瘤的最佳切除边缘仍然是临床辩论的主题.
研究的目的:
- 系统地审查和元分析中等到厚度黑色素瘤的1厘米与2厘米切割边缘的结果.
- 为了比较不同边际大小之间的复发率,无病生存率和重建复杂性.
主要方法:
- 系统审查和元分析遵循系统审查和元分析 (PRISMA) 准则的首选报告项目.
- 搜索了多个数据库 (PubMed,Medline,CINAHL,CENTRAL) 和临床试验注册表.
- 包括七项研究,比较1厘米和2厘米的切割边缘,分析初级和二级结果.
主要成果:
- 在1厘米和2厘米边缘 (p=0.216) 之间没有观察到总体黑色素瘤复发率的显著差异.
- 三项研究报告,无病生存率没有显著差异.
- 1厘米的边缘更容易实现初级关闭,而2厘米的边缘需要更复杂的重建 (p<0.017).
结论:
- 1厘米的切除边缘似乎和2厘米的边缘一样安全,对于中等到厚厚的黑色素瘤.
- 更小的边缘减少了复杂的外科重建的需要.
- 建议进行进一步的随机对照试验,但研究结果支持采用较小的切除边缘.
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