摘要
目的下肢恶性黑色素瘤手术的腹股沟淋巴结清扫范围一直是人们争论的焦点。本研究旨在探讨腹股沟淋巴结清扫范围对下肢恶性黑色素瘤预后的影响。方法共收集34例病例,分为两组,18例仅行浅表淋巴结清扫术(Superficial inguinal lymphadenectomy,SLND),16例联合行髂窝淋巴结清扫术(Combined inguinal lymphadenectomy,CLND),对其进行回顾性分析。结果SLND组与CLND组比较,一般资料无统计学差异,总生存期为46.8 vs 45.1(月,P=0.272);无病生存期为36.1 vs 35.9(月,P=0.719);术后住院天数为16.5 vs 23.0(天,P=0.066);并发症发生率为38.9 vs 75.0(%,P=0.045)。结论对于髂窝淋巴结临床阴性的下肢恶性黑色素瘤,仅行浅表淋巴结清扫是可行的。
Objective The extent of inguinal lymphadenectomy for lower extremity melanoma remains controversial.We reviewed our recent experience to investigate the impact of the therapeutic extent.Methods We performed a retrospective review of 34 patients with lower extremity melanoma,18 of which received SLND(Superficial inguinal lymphadenectomy),the other 16 received CLND(Combined inguinal lymphadenectomy).Results The demographic factors are statistically identical comparing SLNDs and CLNDs.Overall survival is 46.8 vs 45.1(P = 0.272),while disease free survival is 36.1 vs 35.9(month,P= 0.719),days in hospital after surgery is 16.5 vs 23.0(P = 0.066),morbidity rate associated with surgery is 38.9 vs 75.0(%,P = 0.045).Conclusion SLND is recommended in patients of lower extremity melanoma without clinical evidence of deep nodal involvement.
