CAJ | 학술논문

目的探讨手术切除联合生物治疗肢端恶性黑素瘤的疗效.方法应用病灶切除、创面植皮或皮瓣修复的方法,对2004年以来的15例肢端黑素瘤进行手术治疗,切除范围距病灶1～2 cm,其中,4例切除后直接缝合;10例较大损害,切除后植皮及邻近皮瓣转移修复;1例较大损害累及第一跖趾关节,行第一趾截趾并保留趾背皮肤修复足底前端创面.术后肌注α-2b干扰素3个月.结果 15例患者中,肿瘤浸润厚度为1.8～3.9 mm,原位黑素瘤6例,侵袭性黑素瘤9例.术后皮片、皮瓣全部成活,随访1～3年,有1例侵袭性黑素瘤在术后3年复发.术后患足功能正常.结论根据肿瘤厚度决定切除范围大小,联合α-2b干扰素治疗,在避免截肢的情况下不影响患者存活率.
목적 탐토수술절제연합생물치료지단악성흑소류적료효.방법 응용병조절제、창면식피혹피판수복적방법,대2004년이래적15례지단흑소류진행수술치료,절제범위거병조1～2 cm,기중,4례절제후직접봉합;10례교대손해,절제후식피급린근피판전이수복;1례교대손해루급제일척지관절,행제일지절지병보류지배피부수복족저전단창면.술후기주α-2b간우소3개월.결과 15례환자중,종류침윤후도위1.8～3.9 mm,원위흑소류6례,침습성흑소류9례.술후피편、피판전부성활,수방1～3년,유1례침습성흑소류재술후3년복발.술후환족공능정상.결론 근거종류후도결정절제범위대소,연합α-2b간우소치료,재피면절지적정황하불영향환자존활솔.
Objective To investigate the clinical outcomes of surgical excision combined with recom binant interferon aipha-2b in the treatment of acral malignant melanoma (MM). Methods Fifteen patients with acral MM admitted to the department since 2004 were recruited into this study. The tumors varied from 1.8 mm to 3.9 mm in invasion depth. Thin tumors with an invasion depth of 1.8 - 2.0 mm were excised with a margin of lcm beyond the tumors, and those with an invasion depth of 2.0 - 3.9 mm were excised with a margin of 2 cm beyond the tumors. After excision, 4 cases of minor excision were sutured directly, 10 cases of large excision were repaired with adjacent skin grafts and flaps, 1 patient with the involvement of the first metatarsophalangeal joint underwent toe amputation followed by the repair of planta wound surface with the remaining skin on the dorsa of toes. Patients received intramuscular recombinant interferon alpha-2b for 3 months (3 million units daily for the first 3 days and 6 million units for the remaining days) following operation. Results There were 6 cases of MM in situ and 9 cases of invasive MM in this study. All the skin grafts and flaps survived. Within the 3-year follow up, relapse was observed only in 1 patient with invasive MM. Recovery was achieved in the functions of feet in all patients. Conclusion The excision of tumors with a margin determined by tumor thickness plus intramuscular interferon alpha-2h may improve the survival of patients with cutaneous MM in planta pedis with avoidance of amputation.