摘要
目的探讨手足部恶性黑色素瘤(malignant melanoma, MM)的外科治疗方法并对预后进行分析。方法回顾性分析2012年10月-2016年5月收治的21例经病理检查证实的手足部恶性黑色素瘤患者病例资料。病变发生于手指2例,均进行截指术;发生于足部19例,其中6例行MM扩大切除术,13例行MM扩大切除术+植皮术。病灶范围0.5 cm×1.0 cm^4.0 cm×5.0 cm。所有患者术后均未进行放化疗,仅有2例行腹股沟淋巴结清扫术。结果术后随访3~24个月,21例中至今生存16例,2年生存率为76%(16/21),无转移或复发。其他5例分别因脑转移2例、肺转移1例、肝转移1例、全身广泛转移1例而死亡。结论手部MM发现要早于足部MM,且预后良好。足部MM具有很高的转移风险,一旦转移死亡率高。早期发现、诊断并选择扩大切除术或早期截肢治疗,同时行全身检查,如已有腹股沟淋巴结转移,同时进行腹股沟淋巴结清扫可降低转移率,延长生存期。
Objective To discuss the surgical treatment and prognosis of malignant melanoma(MM) in hand and foot. Methods We retrospectively analyzed 21 cases of malignant melanoma in hand and foot who were admitted and treated from October 2012 to May 2007 in our hospital, 2 cases of fingers were performed with finger amputation. 19 cases occurred in the foot, among them, 6 cases underwent MM wide resection and 13 cases underwent MM wide resection and skin grafting. The tumor size of the lesion was from 1.0 cm×0.5 cm to 4.0 cm × 5.0 cm. All patients were not treated with chemotherapy after operation, and only 2 cases of inguinal lymph node dissection were performed. Results Followed up for 3 to 24 months after operation, 21 cases of malignant melanoma of hand and foot survived 16 cases and the 2 year survival rate was 76%(16/21), wiyhout metastasis or recurrence. The other 5 cases died of foot MM, 2 cases died of brain metastases, 1 case died of lung metastases, 1 case died of liver metastases, and 1 case died of extensive systemic metastasis. Conclusion Hand MM is found to be earlier than the foot MM with the prognosis is good. Foot MM has a high risk of metastasis, once metastasis occurs, the mortality is high. Early detection, diagnosis, and selection of wide excision, or early amputation, and general examination, the metastasis rate can be reduced and the survival time is prolonged, if the inguinal lymph node metastasis, inguinal lympl node dissection can reduce the metastasis rate occurs.
作者
朱学超
刘宏君
薛孝威
顾加祥
ZHU Xuechao;LIU Hongjun;XUE Xiaowei(Dalian Medical University, Liaoning, Dalian, 116044, China)
出处
《实用手外科杂志》
2019年第2期195-198,共4页
Journal of Practical Hand Surgery
关键词
恶性黑色素瘤
扩大切除术
手足部
Malignant melanoma
Extensive resection
Hand and foot
