Abstract
Our experience has shown that an increasing depth of invasion of the primary tumor is connected with a higher incidence of regional lymph node metastases. The incidence of subsequent metastases or recurrences is compared retrospectively for two groups: (1) 175 patients with elective dissection and (2) 33 patients with excision only. All patients suffered from high-risk melanomas of clinical stage I. The frequency of subsequent metastases was 21% (N=36) for the first group and 46% (N=15) for the second group (p≦0.01). The 5-year survival rate (Berkson-Gage) of patients with high-risk melanomas and secondaries is 41% for the patient group (N=27) in which elective dissection was performed and 21% for patients with therapeutic dissection (N=52). The results speak for the elective dissection in cases of high-risk melanomas.
Key words: Malignant melanoma, Elective dissection, Therapeutic dissection
Abstract
Nach unseren Ergebnissen ist die Häufigkeit regionaler Lymphknotenmetastasen von der Invasionstiefe des Primärtumors abhängig. Die Häufigkeit späterer Metastasen oder Rezidive wurde bei zwei Patientengruppen retrospektiv verglichen: (1) 175 Patienten mit prophylaktischer Dissektion und (2) 33 Patienten mit alleiniger Excision. Es handelte sich nur um “high-risk”-Melanome im klinischen Stadium I. In der ersten Gruppe betrug die Häufigkeit späterer Metastasen 21% (n=36), bei der 2. Gruppe 46% (n=15) (p≦0.01). Bei Patienten mit “high-risk”-Tumoren und regionalen Metastasen (pathologisches Stadium 2) betrugen die 5-Jahres-Überlebensraten (Berkson-Gage) 41% für die prophylaktisch dissezierte Gruppe (n=27) und 21% für die therapeutisch dissezierte Gruppe (n=52). Diese Befunde sprechen für die Durchführung einer prophylaktischen Dissektion bei “high-risk”-Melanomen.
Schlüsselwörter: Malignes Melanom, Prophylaktische Dissektion, Therapeutische Dissektion
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