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恶性黑色素瘤的区域淋巴结处理至今仍无定论。有人认为限期淋巴结清扫术(ELND)可以延长高危病人的生存期,但随机研究结果表明,如出现淋巴结转移的临床征象,则并不优于治疗性淋巴结清扫术(TLND)。一些学者指出腹股沟淋巴结活检阴性者作浅表淋巴结清扫术(SILND)已足够,同时作股深、回肠一闭孔淋巴结联合清扫术(CLND)仅适用于腹股沟淋巴结阳性者。不过有人认为,深部淋巴结的转移是肿瘤布散的标志,即使清除也并不影响生存率。本文介绍作者于1974～1984年间收治的躯干和下肢黑色素瘤共420例的治疗结果,并就手术切除范围及术后复发情况进行分析。作者对属Clark Ⅲ级以上、肿瘤厚度1.5 mm以
Regional lymph node processing of malignant melanoma remains inconclusive. Some people think that limited period lymph node dissection (ELND) can prolong the survival of high-risk patients, but randomized studies have shown that if the clinical signs of lymph node metastasis, it is not better than therapeutic lymph node dissection (TLND). Some scholars have pointed out that it is sufficient to perform shallow lymph node dissection (SILND) in patients with negative inguinal lymph node biopsy. At the same time, deep femoral and ileal-closed-endoscopic lymph node dissection (CLND) is only applicable to those with positive inguinal lymph nodes. However, some people believe that the deep lymph node metastasis is a sign of tumor spread, even if it does not affect the survival rate. This article describes the treatment results of 420 cases of the trunk and lower limb melanoma treated by the author from 1974 to 1984, and analyzes the range of surgical resection and postoperative recurrence. The authors belonged to Clark III class and above, and the tumor thickness was 1.5 mm.