Surgical treatment for cutaneous malignant melanoma

Abstract

Objective: To investigate the efficacy of surgical treatment for cutaneous malignant melanoma. Methods: Retrospective analysis of clinical records, surgical procedures and the prognosis was performed in 93 patients who were diagnosed of cutaneous malignant melanoma and underwent surgical treatment between October 2007 and December 2011. According to American Joint Committee on Cancer (AJCC) staging system, one patient was in stage ⅠA, two patients were in stage ⅠB, eight patients were in stage ⅡA, nine patients were in stage ⅡB, twenty patients were in stage ⅡC, eighteen patients were in stage ⅢA, seventeen patients were in stage ⅢB, sixteen patients were in stage ⅢC, and two patients were in stage Ⅳ. The surgical procedures include extensive skin resection for 26 patients, extensive skin resection plus construction with skin graft or local flap for 7 patients, finger (toe) amputation for 8 patients, ilioinguinal lymph node dissection for 32 patients, axillary lymph node dissection for 3 patients, extensive skin resection plus one-stage ilioinguinal lymph node dissection for 15 patients, and extensive skin resection plus one-stage axillary lymph node dissection for 2 patients. Fifty-three patients received adjuvant chemotherapy and seventy-eight patients received interferon or interleukin treatment. Of 93 patients, 77 patients were followed-up, with an average follow-up period of 20 months (range: 2-50 months). Results: All of three stage Ⅰ patients survived; of 28 stage Ⅱ patients, 8, 2 and 6 patients had linguinal lymph node, bone or skin metastasis 12, 18 and 36 months after surgical treatment, respectively; of 44 stage Ⅲ patients, 11 patients died of lung metastasis, and 5 patients died of liver metastasis during the follow-up; of 2 stage Ⅳ patients, 1 patients died of lung metastasis 12 months after surgical treatment, and 1 patient died of liver metastasis 11 months after surgical treatment. Of the 77 patients who were followed-up, 43 patients survived with neither local recurrence nor progressive disease. Conclusion: Early diagnosis and surgical treatment of cutaneous malignant melanoma can achieve desirable disease control, and the standardized regional lymph node dissection is important in the control of tumor progression, as well as the adjuvant therapy is benefit for the survival. DOI:10.3781/j.issn.1000-7431.2012.09.013